Magic Algor assists Payers in identifying and recovering overpayments made to healthcare providers.
We apply various algorithm and rules to identify potential overpayment claims. MDI also provides audit review and adjustment services for all such claims. With the combination of our technology and audit capabilities, we have helped Payers recover anywhere between $1 MM to $10 MM annually depending upon their membership base. In addition, we provide Payers with various trend analyses to uncover malpractices, if any. These trend analyses help control fraud and abuse and result in large savings.
Our recovery services are on a contingency basis, meaning our payment is solely dependent on the realizations or offset remittances successfully received from providers.
Increase Acceptance Rate
Identify Overpayment Claims
Quantify Recovery Amount
Perform Trend Analysis
Reduce Fraud, Waste, and Abuse
Healthcare reform and rising costs are pushing payers to reduce under/overpayment errors (to reduce resubmission) and improve claims accuracy. Magic Algor with following features helps you do that:
Scrubbing - Ingestion of claims data from various claims platform to run predefined as well as custom algorithm
User-Friendly - Helps present data in a user-friendly format
Analytics - Perform various trend analysis to highlight malpractices and get other insights
Training - Minimal training required for associates with the user-friendly, flexible interface
Scalability - Highly scalable and configurable technology architecture designed for growth
Recovery - Identify claims with potential overpayment and drive their collection
Efficiency - Identify malpractices; reduce fraud, waste, and abuse
Pay-for-Performance - Contingency pricing model; strong upside potential with zero downsides
Reporting - Generate reports with meaningful insights for appropriate management action
Savings - Easily calculates savings and overall financial impact to the bottom line
We know profitable growth is important to you. Give us an opportunity to partner with you.