AVYM is a leading healthcare reimbursement recovery firm, serving providers, billing organizations, plan administrators and medical device companies in actions involving denied or disputed medical insurance claims.
For many hospitals and providers, “out of network” may mean “out of luck” as they face an increasing number of payers issue total claims denials and overpayment recoupments worth millions of dollars. AVYM has developed the 2013 Out Of Network Healthcare Reimbursement Compliance Program (OHR), focusing on compliance risk management and solutions.
The new protocol consists of two onsite programs and is based on the most recent federal and state judicial decisions and regulatory guidance.
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Is your third-party administrator holding out on you? With more than $19 billion in anti-fraud and overpayment recoupments in the private sector, there’s a good likelihood your TPA has not restored or refunded the full amount to your ERISA plan as required. Our innovative Fiduciary Overpayment Recovery Specialist and Fiduciary Overpayment Recovery Contractor (FORC) programs can help self-insured plans like yours recover assets and protect revenue.