AArete Helps Health Plan Achieve up to 13% in Recoupment and Prospective Savings through Contract Configuration

Situation A managed care organization was experiencing provider abrasion correlated to incorrect reimbursement per provider’s contractual terms and needed to conduct a root cause analysis of their configuration. The insurer approached AArete to perform a detailed review of major provider contracts for ancillary services against claims data to identify overpayments for recoupment, financial volatility, and root…