PAYER SOLUTIONS

Credit Balance Recovery

Let us show you how we identify, recover and even prevent overpayments

TREND accurately & efficiently resolves overpayments and credit balances

We work your credit balances for you, so that you can reallocate
your people to cash generating activities. Our flexible model
allows us to supplement your denial management team when, where, and as you need it.

TREND’s modules analyze insurance paid claims data, COB primacy & transactional data to produce optimal outcomes for our customers.

Total amount a large health system can generate in new credit balances annually

Average age of unworked credit balance accounts

Amount an average sized provider can generate annually in new credit balances

Up front cost to you. 100% risk free, contingency fee based on actual recoveries

TREND has identified

Recoveries

Million in Overpayments

Let’s talk about Payer Challenges

Credit Balance Recovery

Credit balance recovery is a critical component of a mature payment integrity program at any payer. The identification of the claim overpayment occurs outside of the paid claims and eligibility data within the payer’s environment and inside provider data sets. 85-90% of all credit balance overpayments are not identified by the payer’s internal or vendor programs, thus credit balance recovery programs are the perfect supplement to any mature payment integrity program.

Flexible and Focused

TREND partners with healthcare providers to complement their existing processes. We listen to their internal goals and objectives so that our credit balance recovery plan reduces their credit balance inventory while maximizing overpayment recoveries for our clients.

Collaborative and Transparent

Our application provides real-time status updates, an accurate audit trail and comprehensive reporting to provide key insights while more effectively managing this costly business requirement.

Reduce Provider Abrasion

TREND’s recovery analysts offer credit balance resolution services to your provider partners, reducing costs and allowing providers to prioritize revenue generation. These services are typically provided at no cost to the provider.

Seamless Workflow

Ingest Data
TREND ingests data from payers and provider systems
Analyze & Validate
TREND identifies overpayments and resolves credit balances
Approve/Deny
TREND facilitates refunds and manages collection
Resolve & Correct
TREND resolves and corrects errors in payer and provider systems
Reporting & Analytics
TREND delivers root cause reporting and analytics

CASE STUDY

Credit Balance

Plan Overview

State Medicaid Plan
Number of Members – 200K+

TREND reviews, validates and interacts directly with Provider on the Payer’s overpayment inventories that require approval for retraction or check recovery. TREND’S provider access and relationships expedite collections for our clients.

TREND History

Contracted payer for Credit Balance Service replacing another vendor state-wide in 2019

Key Value Drivers

Reduced average days from identification to finalization by 33 days

Reduced payer refund denials by more than 50%

On-site representative reduces provider abrasion and helps create efficiency for Payer and Provider! Faster collection turnaround vs. standard mail/telephone collection process at lower fees that traditional collection vendors.

Annualized Recoveries

Result = 38% Increase in Recoveries

Credit Balance & Overpayment Collections

TREND’s modules analyze insurance paid claims data, COB primacy & transactional data to produce optimal outcomes for our customers

Analysis and Recovery

TREND obtains system access and reports from Providers to identify, analyze and recover client overpayments on accounts residing in a credit balance state.

Seamless Integration and Resolution

We provide resolution to all assigned credit balances, not just refunds, following existing Provider workflows.

Technology-Enabled Solutions

TREND’s comprehensive, technology-enabled solutions and robust reporting allows for deep root cause analysis to help prevent future overpayments.

Getting started with Overpayment Collections

Direct Interactions and Expedited Collections

TREND reviews, validates and interacts directly with Provider on the Payer’s overpayment inventories that require approval for retraction or check recovery. TREND’S provider access and relationships expedite collections for our clients.

On-site Support = Faster Collection

On-site representative reduces provider abrasion and helps create efficiency for Payer and Provider! Faster collection turnaround vs. standard mail/telephone collection process at lower fees that traditional collection vendors.

Get better results, new concepts, automated intelligence

Your Credit Balance Recovery Solution

Credit balance recovery has historically been done the same way by the same people. Now that all changes with TREND. We look at credit balance recovery as an opportunity for true collaboration. When done right, this service is a win-win-win for healthcare providers, insurance payers and TREND.

We look at recovery in the same light. Our on-site relationships with healthcare providers affords us the opportunity to assist them with all types of recovery including those related to credit balance overpayments and payer and vendor identified overpayments. We can do it all!

Payer #1

Multi-State BCBS Plan Multi-Service

“I love TREND’s portal. It is super easy and friendly and has all the information I ever need. I have never had an issue with them. They are very responsive to our questions, produce any information we are looking for, and they are very thorough.”

Provider #2

20 Hospitals
$4B NPR

“TREND is kind of an extension of my team, so what we expect from my team we expect from them… They respond very timely to any question with reports, claim issues, what is the status of an account – their communication is probably one of the best I have seen.”

Payer #3

Single-State BCBS Plan payment Accuracy

“Vendors put on a pony show, and integration with a payer is always a challenge, but not so with TREND–their systems, their workflows, their reporting tools all did what they said, and it was a seamless integration with our process.”