In today's manual environment, on average, patient accounting staffs resolve only two to four credit balance accounts per hour including the completion of necessary hospital paperwork and document gathering.
With the lack of automation, hospitals are forced to dedicate significant staffing or watch credit balances and the associated risk spiral out of control.
Medicare regulations require all providers to report credit balances quarterly. These regulations state "providers must develop and maintain documentation which shows that each patient record with a credit balance was reviewed to determine whether the credit balance is attributable to Medicare".
Not all credit balance accounts are the result of overpayments. In fact, on average, 65% are the result of misposted contractual allowances or misapplied payments.
We serve over 1,000 providers, 32 Blue Cross plans and dozens of major commercial carriers nationwide. Xerox offers superior staffing and technology solutions that set us apart from traditional credit balance vendors. All of our hospital credit balance and recovery services are offered at no cost to the providers we serve.
How Xerox Can Help
CDR Associates is an affiliate of Xerox. CDR is a CPA based healthcare financial consulting firm founded in 1989 to assist health insurers in the identification and recovery of overpaid claims. Since that time, CDR has established itself as the industry leader by completing thousands of onsite audits annually on behalf of Blue Cross and Commercial Payers as well as State Medicaid agencies across the country.
The firm also assists Hospitals nationwide in creating efficiencies to reduce their credit balances. Through the use of proprietary software, CDR has assisted Providers in resolving billions of dollars in credit balance accounts.
CDR Associates conducts on-site credit balance recovery audits to assist insurers in the identification and recovery of overpaid claims. The onsite audits offered by CDR focus on the identification and recovery of three primary types of incorrectly paid and processed claims:
Credit Balance Analysis System (CBAS)
The first system focused exclusively on the credit balance resolution process. CBAS is a revolutionary web-based system that requires minimal hospital information systems department involvement No installation of software or hardware is needed and our clients see immediate increases in staff efficiency and hospital profitability.
CBAS will significantly increase staff efficiencies and productivity by increasing the volume of accounts resolved on a daily basis CBAS will identify billable debit balances currently hidden within credit balance accounts. CBAS automates the process of identifying and reporting overpaid claims to Medicare. For the first time, managers can easily identify potential Medicare liabilities, track the processing of each account and feel confident that the hospital is in compliance with Medicare regulations HIPAA compliant.