Solutions
Performant Healthcare SolutionsSM offers broad experience in the commercial and government-sponsored healthcare markets.
Our experience features the provision of payment integrity services to some of the nation’s largest, national commercial payers, as well as to a host of regional payers and Blue Cross Blue Shield plans. Under these contracts, Performant identifies, recovers, and prevents improper payments through the deployment of advanced data mining technology, automated and complex clinical reviews, coupled with robust provider outreach efforts.
To support a health plan’s cost containment efforts, Performant offers a wide range of services for all lines of business, including commercial, Medicare, and Medicaid. Additionally, Performant leverages nearly 50 years of experience in asset recovery to deliver leading COB/TPL, MSP, provider debt recovery, and health insurance claim administration services.
Our team of highly trained audit professionals includes registered nurses, certified coders, data analysts, recovery specialists, and medical directors brings deep experience with the payment integrity cycle from analysis through appeals to each engagement.
Offering proven industry best practices coupled with a proprietary library of specialized audits, Performant delivers tailored solutions aligned with the payment integrity goals of our clients. Our fast and highly customizable program implementation accelerates savings and recovery, as well as program ROI; and our dedicated team of professionals brings valuable audit and recovery experience and a focus on building long-term relationships.
Our Healthcare and Technology Solutions
Audit Advantage
Data Mining Advantage
MSP Advantage®
Performant deploys a highly trained team of outreach professionals for manual validation of low-quality data matches and to coordinate with the MA plan, CMS, and other coverage providers.
Our solution includes dedicated lockbox services offering complete end-to-end processing and accounting and integrates optical character recognition (OCR) to scan and digitize documents received by mail, maintaining a detailed account record.
TPL Advantage®
While regulations support other forms of coverage as primary before Medicaid, there is no single source from which MCOs can easily obtain information on other forms of coverage. Identifying this information can lead to substantial savings for MCOs.
Our solution includes dedicated lockbox services offering complete end-to-end processing and accounting and integrates optical character recognition (OCR) to scan and digitize documents received by mail, maintaining a detailed account record.
Recovery Advantage®
Performant Healthcare SolutionsSM foundation is built on delivering solutions that quickly and efficiently recover funds due to our clients (e.g., overpayments, debts, aged recoveries). With more than 40 years of recovery experience, we have a proven track record of managing accounts, some of which are in the billions of dollars.
Performant is the leading recovery audit vendor with true recovery/collections experience and an established collections infrastructure.