HRA transforms “zero balance” underpayments into profits

WHAT WE DO

Since 2002, HRA’s recovery efforts on “zero balance” accounts have yielded millions of dollars in additional revenue for our clients. We use proprietary technology, including machine learning and natural language algorithms, to sift through data — and then our team of highly trained professionals identifies undervalued claims, coding errors, and other issues to identify missed revenue opportunities.

1-3% of net managed care revenues identified
2 years of records retroactively investigated
90% rate of recovery on your lost revenues
Millions of dollars in recovered profits

Our Fee Structure

To maximize our value to you, our fees are 100% contingency-based. HRA only gets paid after a recovery is fully processed, paid, and recorded in your system. No up-front costs are involved, so your financials will never be adversely impacted by retaining us. The accretive consulting that we provide to each of our clients to guide them toward process improvements are also included as part of our fee.

Underpayments by Contract

During our payment review and audit, we comprehensively study all zero balance managed care accounts, specifically looking for coding validations and coding errors. These two items can represent a high source of revenue leakage, leading to incorrect documentation and reimbursement. As an integral part of our accretive consulting services, HRA is committed to finding ways to prevent future revenue leakage.

Underpayments by Error

HRA’s software platform can generate ad hoc reports tailored to your facility’s needs, which is valuable to both current operations and future contracting. We can reveal the common errors made by each third-party payer and identify contracts with high rates of underpayment by error across categories such as stop-loss, silent PPOs, missed filing deadlines, CPT coding and outlier rates.

The Benefits of Working with HRA

  • No fees unless we make a recovery
  • Positively impact company profits
  • Results delivered within 90 days
  • HIPAA-compliant systems and software
  • Comprehensive recommendations
  • Minimal interruption to your staff

Our 4 Step Engagement Process

the first step of our 4 step engagement plan
Plan the project
the second step of our 4 step engagement plan
Audit patient accounts
the third step of our 4 step engagement plan
Pursue unbilled and/or underpaid balances
the forth step of our 4 step engagement plan
Provide reports and recommendations

OUR TECHNOLOGY

Healthcare Retroactive Audits is an industry leader when it comes to innovation and technology to maximize your profits. HRA auditing utilizes sophisticated stack technology, robotic process automation, machine learning, natural language algorithms and advanced analytics. We then apply our proprietary artificial intelligence software to identify your revenue opportunities.

  • Stack Technology
  • Robotic Process Automation
  • Machine Learning
  • Natural Language Algorithms
  • Advanced Analytics
  • Proprietary Artificial Intelligence
This is a picture of a girl in professional dress that represents some of our workers

OUR PEOPLE

HRA invests significant resources into training our technology-driven, in-house team of talented professionals. From nurse auditors to AI developers, the entire team is focused on every detail of your Zero Balance managed care underpayments on a case-by-case basis, including:

  • Identification verification
  • Undervalued Claims
  • Coding Errors
  • Challenging medical necessity denials
  • Enforcing managed care contract compliance
  • Revenue leakage