expert medical claim audit services
OUR MISSION
At Smart Revenue ResQ, our mission is to help assist health plans and provider groups with their managed care contracts, utilizing our extensive experience in this space to maximize revenues and claim payments.
Our services
At Smart Revenue ResQ, we are dedicated to ensuring equity and fairness in medical claim payments. Founded by Todd Whitney, a seasoned Health Insurance Actuary with extensive experience in managed care organizations, medical claim audit services, overpayment recovery, and healthcare plan administration, our company brings a unique perspective and a wealth of knowledge to the table. Over the past decade, we have successfully recovered over $25 million for our clients, which include numerous large physician groups and health plans across the country.
Our primary focus is on reviewing and recovering claims that have been denied or paid incorrectly, and identifying funding shortfalls. We utilize advanced software algorithms to evaluate and test provider and benefit configurations, ensuring compliance with plan benefits and identifying cost-saving opportunities. Our contingency-based service model ensures that we are as invested in the success of your claim recovery as you are. We advocate for our clients with payers and share our findings to enhance the productivity and efficiency of your staff.
Smart Revenue ResQ prides itself on its proven methodologies and commitment to client success. Our comprehensive process includes securing necessary documents, uploading health plan data to our secure server, reviewing claims against contract terms and payment rules, and tracking adjustments to ensure accurate payments. We are committed to maximizing incentive payments and ensuring that our clients receive the full benefits of their managed care contracts.
Partner with us today and put our expertise to work for your organization.
