Leco & Associates

				Helping hospitals achieve fiscal fitness.

Managed Care Recovery

Managed Care contractual revenue is a significant part of every hospitals' payer mix. Many hospitals lose as much as 7% of their legitimate managed care revenue due to underpayments and denials of claims. Payers often underpay claims when they fail to adhere to the complex provisions of their contracts with your hospital. This is especially true with regard to stop-loss clauses, case rate exclusions, carve-outs and levels of care.

Leco's managed care contract compliance review begins with a simple down load of your managed care billing and payment information. We use our proprietary software that employs sophisticated data mining techniques to highlight all potential errors. Our experienced contract analyst then corroborates each deviation against the pertinent contract terms and documents each underpayment.

Our account recovery specialists use remote access into your billing and collection systems to validate each error before comtacting the insurer to request reimbursement. We tenaciously follow up until full payment is received by your hospital.

At the end of our review, We provide you with a comprehensive analysis of all payment discrepancies detailing the sources by payer and by type of error. We also provide you with suggestions on how to increase your reimbursement rates by negotiating improved contract terms.

This service is completely self-funded by our recovery of additional revenue and provides you valuable information on how to achieve improved reimbursement on future managed care contracts.