Our HIT and DME claims auditing procedures and proprietary software focus solely on overpayment drivers in Home Infusion Therapy and Durable Medical Equipment. Our unique technology, in combination with our team of pharmacy professionals with real-world HIT / DME experience, results in greater recoveries for our clients.
Growing service opportunities attract greater risks for fraud. HIT and DME services have quickly grown into a multibillion dollar industry. When costs are so great, it’s critical that you pay only for the products and services your members need and receive.
Where are your reimbursements going – and for what? Even the most tightly run HIT / DME programs have HIT or DME billing errors and overpayments. And the specialized nature of this medicine and equipment can translate into millions of wasted dollars.
You can control your HIT / DME claims costs more effectively with HIT / DME claims auditing services from Xerox. We help you detect and prevent fraud, waste and abuse and recover lost funds with a combination of automated tools, onsite auditing procedures, and teams of industry experts. And we conduct HIT / DME claims audits professionally to preserve your relationships with providers. We ensure everyone supports one goal: giving patients the care they need – responsibly.
Effective HIT / DME claims audits begin with knowing where to look for potential recoveries. Our automated solutions streamline the process by analyzing and ranking 12–24 months of HIT / DME claims data. We review factors such as billing volume, claim patterns, reimbursement rates and other signs of abuse or non-compliance. You can further refine results by provider, therapy, equipment or even patient condition. By targeting providers with the greatest potential recovery initially, we help generate larger recoveries faster.
Our tools also save time during the audit process. We can compare chart and claims data, providing you access to discrepancies between what was ordered by the physician and billings. We share the data via a secure website, so you receive reports as soon as they are finalized.