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Cost Avoidance and Audit Solution

Our Audit Solutions are designed to help healthcare payers reduce and ultimately prevent inappropriate or incorrect payments. Through our Data Mining and RAC-like business rule engines, we identify and track accuracy and necessity of payments. These are designed to pinpoint coding errors and reduce billing.

We process live and historical claim data through our detection engine in order to identify services that do not comply with billing rules. Suspect claims that require additional review are also identified and managed through an exception handling process.



Client Thoughts

"The dedication from our e4e teams to provide the best possible services is beyond comparison."

"We are amazed and pleased with…the difference the e4e team is making to our inventory levels."

"All work being performed by you is good and very well appreciated."

"We really appreciate all that you do to help make us a better company and increase our business's revenue."

"e4e continues to be a key player in the success of our company."

"They are very accurate in their work and are very responsive to our changing needs."

"By utilizing your services, we are able to focus more on our client and strengthen our core delivery."

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Provider Solutions

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Benefits of e4e's Cost Avoidance and Audit Solution

With e4e's Cost Avoidance and Audit Solution, you can benefits from:

  • Identify and stop inappropriate and incorrect practices and recover funds, thereby dramatically improving your own financials
  • Meet State and Federal regulations
  • Avoid costly investments in analytical systems for identifying 'rogue' providers and suspect billing practices
  • Strengthen provider relations

Why Choose e4e's Cost Avoidance and Audit Solution

With 81 unique fields in Hospital Claim forms, the permutations of possible errors are immense. However, some of the errors or a combination of errors may or may not have material impact on reimbursement. Working with our clients, we have the experience and ability in identifying edits with highest "historical rate" and "probability of error" that relate to medical necessity and have the maximum monetary impact from which you will benefit.