HDM Corp., an Omaha, Neb.-based company has partnered with Costa Mesa, Calif.-based TC3 Health Inc. to offer its clients services for dealing with overpaid healthcare claims.
TC3 Health will provide HDM Corp. payer clients with technology and services that detect overpayments and handle recoveries on claims with abusive coding or fraudulent patterns.
The savings generated will help clients manage their healthcare expenses by product.
"We are pleased to be working with TC3 Health on this partnership to improve the bottom-line results of our clients' healthcare products," said Lisa Lechowicz, CEO and founder of HDM Corp. "TC3 Health's claims management, fraud and abuse expertise and technology drives claims costs lower. Further, aligning with a partner who uses technology and seasoned fraud and abusive coding experts for results supports our mission to find a better way to administer healthcare."
State, federal and commercial payers now are requiring anti-fraud and abusive coding discovery and recovery programs. CMS soon will be awarding four regional contracts under their Medicare Recovery Audit Contractor, or RAC, program.
"A report published in the Journal of American Medical Association disclosed that 54 percent of physicians surveyed reported using deception of payers to obtain benefits, and 39 percent of physicians surveyed reported exaggeration of a patient's condition, diagnosis or symptoms to obtain further benefit," noted George Bregante, chairman of TC3 Health. "The problem is real, and HDM and TC3 are up to the task of discovering and recovering such overpayments that reduce HDM Corp.'s clients medical cost."