Audit & Recovery

Healthcare coding and billing policies are constantly in flux, which makes it difficult for many organizations to keep up with the changes. This is where Performant Recovery steps in. At Performant, we understand the importance of maintaining the integrity of our clients' programs, and we provide client-specific audit and recovery services tailored to maximize recoveries and correct improper billing practices.

Performant offers a wide range of client-specific audit and recovery capabilities with a depth of resources to support diverse business environments. Our experienced medical team and data technology allows us to screen, review and evaluate millions of medical claims to identify improper payments.

This flexible audit and recovery technology platform is specifically designed to accommodate an extensive scope of business functions. Performant utilizes both broad-focused analyses that look at trends and identify unusual patterns across the spectrum of billing activity, and identification tools tailored to the nuances of a specific type of billing activity.

In the last five years Performant has aggressively expanded its audit recovery services and capabilities from federal agencies to state and commercial payers.

Capabilities

  • Comprehensive audit and recovery strategies to meet client-specific needs
    • Automated Audits
    • Semi-Automated Audits
    • Complex Audits
  • Detecting improper payments and FWA
    • Medical Necessity Review
    • Correct Coding Validation
  • Medicare and Medicaid Audit & Recovery services
  • Pre- and post-payment claims auditing services
  • Risk assessments
  • Managing and analyzing large volumes of data
  • Audit report writing
  • Quality Assurance management
  • Project administration and management
  • Efficient detection methods
  • Understanding control systems and weaknesses
  • Provider outreach and education
  • New Issue Development
  • Detection and identification of fraud, waste and abuse
  • Customizable, proprietary, cross-platform audit software
  • Comprehensive audit, including automated, semi-automated and complex reviews