HealthDataInsights has developed a set of technology-based precision audit tools that assist Insurers and TPAs in their efforts to minimize fraud, abuse and overpayments. HCARE delivers positive bottom line results through the recovery of CPT-based professional services claim overpayments and a myriad of other claim overpayments, which are identified through our unique data query processes.

Our audit technology and recovery services have provided large insurance companies and self-insured entities with the benefits of a comprehensive retrospective claim audit and recovery solution that is unmatched by any other company. With the aid of our CPT claim experts and billing specialists, HDI has developed a sophisticated program with a proven track record of identifying CPT-based overpayments, duplicate payments, and various claim payment errors.

In addition to our audit and recovery programs for individual and group medical plans, HDI also audits the medical portion of Workers' Compensation claims.

Because we audit 100% of the claims, maximum results are achieved and supported - this is not a statistical auditing program. The capstone to our audit is our recovery unit, which is staffed by CPT claim specialists and claim payment experts who are uniquely trained and supported by our in-house recovery system.

HCARE assures clients of a customized audit with solid customer service support. Our experience with large sets of data (our largest clients pay in excess of $1 billion annually), combined with our cutting-edge computer technology resources, ensure that we deliver the results our clients expect.

		Our results demonstrate that 10% to 15% of the providers represent 80% to 90% of the overpayments
		Recovery of overpayments that delivers quantifiable, positive results
		Identification of opportunities to reduce ongoing claims cost through operation improvements