CERiS White Paper Highlights the Benefits of Pre-Payment Claim Review | New

The company is a leader in payment integrity solutions

FORT WORTH, Texas, Aug. 16, 2022 (GLOBE NEWSWIRE) — CERiS, a CorVel company and a leader in pre- and post-pay healthcare claims review, today announced a newly released white paper on the payment integrity that urges health care payers to consider a pre-payment claims review strategy while outlining the challenges and benefits of doing so.

The white paper notes the benefits of undertaking such reviews before money changes hands. Among them:

  • It can take months to undo an overpaid claim
  • Payers generally do not recover all money wrongly paid following a post-payment review
  • Reviewing disputed claims often requires a lengthy appeals process
  • Pre-payment reviews avoid “provider abrasion” by paying the claim correctly the first time

In cases where CERiS has provided pre-payment reviews of claims, the average savings per claim can be as high as $9,000, while the claims appeal rate can drop from 10% to 3%.

“Since 97% of all negotiated hospital claims contain at least one billing error, moving to pre-payment review can avoid many of the pain points associated with post-payment claim review and recovery, said said CERiS President Greg Dorn.

The Payment Integrity White Paper can be downloaded here.

About CERiS

CERiS, a leader in the review and repricing of prospective and retrospective claims, combines clinical expertise and cost containment solutions to ensure accuracy and transparency in healthcare payments. Accuracy and validation services include detail review, DRG validation, facility repricing, contract and policy applications, implant and device review, and primary payor cost avoidance. Its proprietary universal chargemaster contains billions of charge items from more than 97% of hospitals nationwide, helping to ensure the accuracy and objectivity of every claim review.

About CorVel

CorVel Corp. applies technologies such as artificial intelligence, machine learning, and natural language processing to improve care episode management and related healthcare costs. We partner with employers, third-party administrators, insurance companies and government agencies in the management of workers’ compensation and health, auto and liability services. Our diverse suite of solutions combines our integrated technologies with a human touch. CorVel’s personalized, locally delivered services are backed by a national team to support customers and their customers and patients.

Safe Harbor Statement under the Private Securities Litigation Reform Act of 1995

All statements included in this press release, other than statements or characterizations of historical fact, are forward-looking statements. These forward-looking statements are based on the Company’s current expectations, estimates and projections about the Company, management’s beliefs and certain assumptions made by the Company, as well as events beyond the Company’s control, all of which are likely to change. These forward-looking statements include, but are not limited to, statements relating to pre- and post-payment healthcare claims review services and the Company’s continued investment in these and other innovative technologies, and statements relating to the Company’s employee compensation service offerings. These forward-looking statements are not guarantees of future results and are subject to risks, uncertainties and assumptions that could cause the Company’s actual results to differ materially and adversely from those expressed in any forward-looking statement, including the risk that the impact of the COVID-19 pandemic on our business, results of operations and financial condition is greater than our initial assessment.

The risks and uncertainties mentioned above include, but are not limited to, the factors described in this press release and the Company’s filings with the Securities and Exchange Commission, including, but not limited to, the “Risk Factors” in the Company’s Annual Report on Form 10-K for the year ended March 31, 2022, and the Company’s Quarterly Report on Form 10-Q for the quarters ended June 30, 2022, the September 30, 2021 and December 31, 2021. The forward-looking statements contained in this press release speak only as of the date on which they are made. The Company undertakes no obligation to publicly revise or update any forward-looking statement for any reason.

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