Clinical Staff


Finding Errors that Others Overlook
Our nurses make the difference. Our clinical expertise and technology reclaims excessive or inaccurate healthcare overpayments through pre- and post-payment cost reduction strategies. They use their clinical and coding expertise to target inaccurate reporting. Quite simply, they find errors that others overlook. Our nationwide team of experienced nurse auditors are reviewing cases with improper payments, incorrect coding, or where unnecessary or inappropriate. The nurses have the balance between clinical expertise, process knowledge, and contractual allowances necessary to assure payment integrity.  

The nurses use a combination of data and chart reviews to assess the clinical appropriateness of patient services across the continuum of care.  They are evaluating clinical detail and treatment patterns to consider the severity of illness, co-morbidities and complications, as well as the intensity of services being delivered.

They have expertise is in traditional bill audits, DRG validation, drug audits and other audit types. Nurses are trained to perform comprehensive analyses of complex claims. The team includes proficiency in all medical specialties. 

The nurses use a holistic approach in working with providers to complete audits and recover payments. Their manner is always collaborative, preserving positive relationships.