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APC Integrity

Accuracy in outpatient billing is a critical challenge for all healthcare providers, but an area that historically has been neglected by many.

The Claro Group's APC Integrity Program is a comprehensive outpatient billing program – comprised of education, infrastructure, monitoring and tools – designed to help providers capture accurate reimbursement, reduce back-end rework and denials, and accelerate cash.

This APC Integrity program addresses the key challenges that can affect a provider's ability to achieve accurate and complete reimbursement for outpatient services:

  • A high volume of low-dollar accounts
  • Short patient visits, presenting a small window of time to organize billing details correctly
  • Complex and confusing coding/billing requirements
  • Integration of multiple parties involved in an outpatient claim
  • Limited visibility and understanding of errors and omissions among clinical departments
  • Frequently changing rules and requirements

Using fact-based analysis, The Claro Group helps providers of all sizes identify opportunities to gain both immediate and sustained financial benefits, including reduced rework, accelerated cash, and increased net revenue.

The complexities of APC/Outpatient billing are compounded by the various stakeholders and processes that must be effectively integrated in order to receive accurate and timely reimbursement.

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Please contact us for more information about The Claro Group's Healthcare Provider Solutions.

Case Studies
Third Party Insurance Recovery
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image Asbestos coverage-in-place settlement
First Party Insurance Recovery
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image Hurricane-related deepwater rig loss
Sourcing and Procurement
image Healthcare Group Purchasing Organization
image State-centralized Procurement Agency
Healthcare Provider Solutions
image Academic Medical Center (Northeast)
image Community Hospital
More Case Studies image Case Study
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