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Case study: How Health Partners Plans recovered a >$1M overpayment

Recovering overpayments from providers is often contentious, requiring payers to perform advanced statistical analysis and extensive medical record review to confidently request reimbursement. Actually seeing an investigation through to completion and recovery requires extensive statistical analysis, teamwork, and communication.

Our new case study details how Health Partners Plans, a not-for-profit managed care organization serving more than 258,000 Medicaid, Medicare, and CHIP members in Pennsylvania, successfully recovered more than $1 million in overpayments related to upcoding from a provider group.

Download the case study here to get the details.

Read the case study

Are you attending NHCAA's Annual Training Conference October 15–18 in Nashville? Health Partners Plans will join us to discuss the same statistical sampling techniques used to help recover this overpayment. Learn more about our presentation and what we have in store for you at booth #107.

 

WRITTEN BY

Leslie Groves
As director of product marketing, Leslie Groves is responsible for the go-to-market planning and execution of Cotiviti's Payment Accuracy solutions. She brings more than 20 years of healthcare marketing experience in leading cross-functional teams to successfully launch information technologies and analytic services to the payer and provider markets. Prior to joining Cotiviti, Leslie held various marketing management roles at Aetna, Cigna, United Healthcare, and Optum with a wide range of responsibilities covering strategy, communications, event management, and product marketing. She holds master’s degrees in organizational leadership from The Graduate Institute and in research and measurement from Southern Connecticut State University.

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