PaidInRed.com modern logo, we are a forensic audit company matching paid to make sure Paid in Full.

PaidInRed.com

Forensic auditing matching contract paid amount, to amount sent as payment. Stop being PaidInRed

No

The most important thing to for you to understand and for the hospitals to
understand is ... Our forensic auditing team is specifically auditing their
ZERO BALANCE "PAID IN FULL" claims. They are NOT auditing the claims that
are in the billing process nor are they auditing the denied or partial paid
claims. We are NOT looking for billing errors to fix or re-bill with
different modifiers. We have a process to identify a very substantial
amount of money that was UNDERPAID by the insurance companies they have
contracts with. If they were to run an A/R report these "PAID" claims
wouldn't even be in the report. We assume that these claims were billed
correctly, the payers paid the claim with no denial codes and the hospital
filed it as "PAID". That said, we find a lot of money on old claims that
have NO value to the hospital. They would never go back and try and get
more money out of them because they are "PAID". We do NOT go after patient
responsibility and we never upset the payers. We have a "soft" appeals
method which works very well for us.

It's important to note that the majority of the contracts allow you to
appeal claims paid incorrectly up to 12 months (some 18 to 24 months) from
the last response sent from the payer. After 12 months the payers are no
long legally responsible to pay the under paid claims. I have literally
seen hundreds of thousands of dollars expire because the CEO dragged his
feet to sign the agreement.

Medical