What if you could reduce your healthcare spending while improving healthcare plans and protecting employees?


We identify and prospectively stop fraudulent claims in real-time before payment

Most, if not all, healthcare analytic companies perform their analytics in a batch mode looking back to retrospectively identify fraudulent claims that have already been paid. THEN they attempt to collect the money that has already been sent and cashed, the national average recovery rate is approximately a dismal 0.33% of all paid claims dollars.

Why not stop bad claims before they are paid?

HealthcarePays has partnered with the best analytic companies in the world to identify and stop fraudulent, wasteful, and aberrant claims immediately after adjudication and before payment.


Protecting employees and fulfilling responsibilities under ERISA

Every day you can find new reports where an employee’s healthcare identity has been breached or stolen. Not only can this affect an employee’s credit rating, but can also affect medical coverage in the future!

HealthcarePays helps employers meet their responsibilities under ERISA by not only preventing improper payments, but also streamlining and improving audits of their healthcare spend.

We like to look at it this way: instead of looking for a needle in a haystack, we provider the employer a handful of needles to review.


We populate a real-time one-of-a-kind cross-payer, cross-provider, and cross-patient repository database of the claims that are about to be paid

Most self-insured employers do not know what they have paid for!

HealthcarePays populates a cross-payer, cross-industry database that houses de-identified claims data that have been adjudicated and are awaiting payment.

The data can be utilized in a wide variety of different forms and formats to provide up-to-the-minute information on claims that are running through the system.


Reducing the cost of healthcare for employers

Depending on the study cited, an estimated 6% to 30% of an employer’s healthcare spending is lost to fraudulent or wasteful healthcare payments.

Just by making a simple change, we believe the typical employer can identify and save 6% with our solution, and in some cases even more.

In order to realize a reduction of cost for employers, our solution creates layers of analytics and payment integrity that stops fraudulent or inappropriate payments in real time — most importantly, before the payment goes out the door.

Sound familiar? It should, the credit card industry has been doing something similar for decades.


Enabling employers to provide better healthcare

One common complaint from employers is they know what they spend on healthcare but do not know what they bought.

HealthcarePays provides employers with HIPAA compliant data that can yield powerful insights into how their healthcare dollars are being spent.

Which enables employers to provide healthcare that is not only more competitive, but also for the grading and measuring ROIs on important programs like disease management programs and wellness programs, resulting in better care and lower costs.

Employer Benefits:

  • Reduce overall healthcare cost by reducing fraud and waste
  • Have deeper and richer data available for various uses including negotiation points when they bargain with health plans to lower administration fees and premiums
  • Protecting your employees from the results of data breaches and identity theft
  • Mitigate risk under ERISA laws with a proactive approach to insuring fraudulent and wasteful claims are not paid

Would like to know more? Let’s discuss!

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