Credit Balance Recovery

Developing strong provider relationships through transparency and collaboration are key to maximizing recoveries for your health plan

The Challenge

Hospital patient accounting staff are often overwhelmed daily with all aspects of the revenue cycle operation. Credit balances remain largely untouched and aged. Limited resources make it almost impossible for hospitals to actively work and resolve their entire inventory of credit balances, many of which are overpayments due to insurance payers.

The Solution

TREND recovers credit balances on behalf of our insurance payer clients as an extension of the provider’s business office. Our recovery analysts take ownership of their assigned accounts to bring them to an accurate and efficient resolution to minimize provider abrasion. Developing strong provider relationships through transparency and collaboration are key to maximizing recoveries for your health plan.

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

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 employs a very skilled and experienced team of recovery analysts that provide credit balance resolution services to your provider partners. Our analysts can work as an extension of the provider’s business office to reduce existing labor costs and allow providers to focus their efforts on revenue generating activities. In most cases, these services are provided at no cost to the provider.

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!

 

Our Service Modules

Below are the service modules found in TRENDConnect™ which support our Credit Balance Recovery service:

TRENDResolve™ is a game-changer

Secure, cloud-based application

Our unique solutions are built on an advanced HIPAA-compliant, cloud-based technology platform that helps our payer partners to reduce redundancy, minimize cost, and manage resources more effectively.

Built from the ground up

Our application is a comprehensive, technology enabled solution created from a configurable suite of business process modules designed to minimize the cost and maximize the efficiency of the payer’s payment integrity program.

Dynamic dashboard reporting

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

TRENDSubmit™

Use our TRENDSubmit™ service module to efficiently track and resolve overpayments that are often lost in transit from the provider to insurance payer. TRENDSubmit™ allows any provider to electronically submit overpayments directly back to insurance payers. This is a real-time, HIPAA-compliant solution that accommodates both refund checks and retraction based overpayment recoveries. 

This service module is truly a benefit that insurance payers can offer to their provider partners, especially where on-site credit balance reviews are not ideal, to bolster their recoveries and reduce provider abrasion. Check out the many benefits TRENDSubmit™ can have for your provider partners.

 

Collaborative and Transparent

Manage, track, submit and report on your inventory of credit balance overpayment recoveries. 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.

Complements Your Existing Process

The utilization of the application is easy to implement and is provided at no cost. Providers will work through their existing processes to identify credit balance overpayments then submit for payer review and approval through TRENDSubmit™.

Credit Balance Resolution Services

TREND employs a very skilled and experienced team of recovery analysts that provide credit balance resolution services to providers. Our analysts can work as an extension of the provider’s business office to reduce existing labor costs and allow providers to focus their efforts on revenue generating activities. In most cases, these services are provided at no cost to the provider.

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