Rising health care costs are one of the biggest problems facing health care organizations today.Left unmanaged, large claims can quickly spiral out of control.
Backed by a strong management team and adhering to strict quality protocols, we combine our knowledge of insurance, risk management and medical best practices to evaluate and assess risk from a business and medical perspective and gain control over these costs.
Our services include:
▪Data Mining & Reports
▪Fraud & Abuse
▪Preferred Provider Organization
▪Real Time Auditing
▪Utilization Management & Review
▪Real-Time Clinical Medical Audit
We are specialised in a pro-active quality and cost containment approach in health care, referred to as Real Time Auditing, where an auditor (sometimes referred to as a shadow doctor) is present during the course of treatment.
Real time audits decrease the likelihood of errors and maximise patient satisfaction. They require well trained auditors and are performed by highly experienced staff that includes physicians and nurses.
From an error detection perspective they offer significant advantages to other prospective and retrospective medical record reviews.