What exactly is a "this can’t be really happening" claim?
It’s unfair. It’s inaccurate. It’s unreasonable.
It’s a fact, 80% of all medical claims contain errors*. Coupled with the rising cost of healthcare, health benefits have become unaffordable and unsustainable.
Bringing healthcare payment integrity and transparency to the entire healthcare industry, WellRithms works side-by-side with self-funded payers in the areas of group health and workers’ compensation, offering a wide-range of cost containment solutions to help you offer sustainable benefits to your participants.
How We Work
WellRithms uses a multilayered reimbursement approach that includes advanced medical experience, data analysis, proprietary and proven processes to review medical claims and determine the right price for medical services. For the payer, WellRithms detects and eliminates errors, fraud and abusing billing to maximize savings on every bill. For providers, WellRithms champions appropriate and equitable reimbursement for services. And your people just win!
Three Steps to Understanding Our Payment Integrity Process
Itemized Bill Review
WellRithms cleans every claim with our line-by-line Classification, Edits, and Audits (CEA) system to uncover coding errors, inappropriate and duplicative charges, and more.
Clean claims are repriced using multiple data sources and proprietary algorithms to determine a fair and reasonable payment amount.
Shield Saving Guarantee
Our reimbursement determination is backed by WellRithms Shield, an ERISA compliant risk transfer tool protecting the plan and patient from financial liability above the plan's allowable amount.
WellRithms is the industry leader in healthcare cost-containment reimbursement methodology for self-funded markets. Committed to pursuing a fair price for healthcare services, we consistently outperform the competition by providing validated savings, backed by a savings guarantee.
See what’s possible with a WellRithms claims analysis.
Step 1 - Schedule a Call
Step 2 - Meet with Us
Pick a date and time that works best for you.
We’ll discuss your problem claims and how we can help.
Step 3 - Send Us Your Claims
We welcome the opportunity to demonstrate how much you could save, at no cost or commitment to you.
*Source: Beckers Hospital Review