Safeguard Your Healthcare Dollars
finHealth's solution provides true insights and real data into healthcare spend. Our advanced data analytics uses proprietary algorithms to perform comprehensive analysis identifying errors, waste and overcharges. Our services ensure resolution, accountability and confidence for health plan fiduciaries. We back our results, putting 100% of our fees at risk.
Access, Understand, & Take Action with Your Claims Data
1
Analyze
finHealth provides Independent, unbiased real time analysis of 100% of medical and pharmacy claims.
• Pre-payment claim verification of high-dollar claims ensures reasonable and customary amounts, avoiding erroneous errors for timely resolution BEFORE payment goes out.
• Post-payment analysis on a weekly or monthly retrospective basis identifies errors and waste for timely resolution.
2
Identify
Issues identified include eligibility, coding, missed provider discounts, duplicate payments, hospital billing errors, subrogation, improper site of care, inflated provider billing, fraud, and more. Data is evaluated using proprietary algorithms and compared to industry cost benchmarking data to determine a “Fair Pay” amount.
3
Resolve
finHealth works with your carrier/TPA/PBM for proactive resolution of all exceptions identified. In addition, we provide strategic insights and recommendations such as:
• Modification of claim processing protocols to ensure compliance with regulatory requirements
• Optimization of Summary Plan Documents to promote future costs savings and employee health literacy
• Plan Design & edits
• Pharmacy strategies
7.8:1 Hard Dollar ROI
15M Claims Processed Annually
700K Lives Serviced
20+ Customers