Zero Balance Review & Underpayment Recovery

Today’s Zeros, Tomorrow’s Heroes

Recover your underpaid and inappropriately denied revenue with our expert-driven zero-balance review.

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Improve Margins

With margins under attack, healthcare providers must fight for appropriate reimbursement across all claims.

Optimize Resources

Revenue cycle teams are stretched, let our underpayment recovery experts prioritize your zero-balance accounts.

Recover Hidden Underpayments

Generate new revenue from your closed or underworked zero-balance accounts.

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Your Safety Net to Underpayments

As your safety net, we work as an extension of your team. Our underpayment recovery experts leverage our technology to identify opportunities to recover otherwise lost revenue from your commercial and government payers.

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Comprehensive Review, Complete Recovery

Our Zero-Balance Review is not limited by dollar thresholds or to known payment variances and denials - it's comprehensive and complete. Unexpected additional revenue often comes from:

Payer-Related
Full & Partial Denials
Processing Errors
Stop-Loss/Outliers
Implants & Supplies
Revenue Cycle Related
Missing Diagnosis
Transfers/Modifiers
Missing Insurance
Payer Edits
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Prevent Underpayments, Preserve Revenue

With ongoing reimbursement challenges, why not eliminate preventable underpayments?  Our actionable reporting and detailed root-cause analysis pinpoint process improvement opportunities while providing leverage for upcoming payer negotiations.

Actionable Reporting (Payer & Claims-Levels)
Detailed Root-Cause Analysis
How it works

Our Zero-Balance Review Process

Identify
Identify Underpayments

We combine technology with underpayment recovery experts to identify additional sources of revenue.

Recover
Recover Lost Revenue

Our dedicated underpayment recovery experts recover underpaid and denied revenue from Commercial and Government payers.

Prevent
Prevent Underpayments

In-depth reporting and root-cause analysis help you stop losing revenue to preventable underpayments.

Ready for a Boost?

Schedule time with our experts – together, we’ll develop a game plan for recovering your missing revenue.

Talk With an Expert
Recover Unknown Lost Revenue
Eliminate Preventable Underpayments
Prioritize & Optimize Revenue Cycle Resources
Why Boost Healthcare

Zero-Balance Review, Done Right

No Underpayment Too Small

We comprehensively review 100% of your claims and pursue even the lower-dollar underpayments – we do not cherry-pick.

Payer Familiarity

We have a proven track record of recovering the unexpected.  In fact, 80% of our verified underpayments are paid within 60-days.

Intelligent Review

Our technology and underpayment recovery experts identify and recover otherwise lost revenue due to unknown or under-worked underpayments and denials.

Dedicated Team

Because each healthcare provider is unique, we don't commingle or pool together claims from multiple clients. You are assigned a dedicated team that operates as an extension of your own.

"Boost not only works our accounts but provides education back to us to foster a proactive approach to increasing cash collections and decreasing aged bad debt by our internal collections staff.  Boost dives into our payer contracts and works directly with the insurances to hold them accountable to reimburse our facility at the correct rates.  They are a Revenue Cycle Management partner for our facility and are readily available to assist us with difficult payers and account denials as needed."

Revenue Cycle Leader
Stand-Alone Hospital
FAQ

Frequently Asked Questions

What is a Zero-Balance Review?

While the types and quality of a Zero-Balance Review can vary, the purpose of a Zero-Balance Review is to review closed/zero-balance insurance accounts to identify and recover previously unknown or unrecovered underpayments across Commercial, Government, and Government-like payers.

Why have a Zero-Balance Review?

For most, a Zero-Balance Review can be a consistent “Safety-Net” that complements your existing internal and outsourced efforts to ensure previously unknown underpayments are identified and recovered across your Commercial, Government, and Government-like payers.

What if our contract management tool identifies payment variances?

While most contract management tools do a really good job of identifying payment variances within routine claims that are more straightforward, the accuracy is often subject to the individual loading the contract and its various contractual components. Unfortunately, it's not uncommon to see more complex claims (i.e., COB Issue, Corrected Claim, Late Charges, etc.) either bypass the contract management tool's pricing model or be modeled against the wrong contract.

Who’s a good fit for a Zero-Balance Review?

Usually, any hospital or health system that meets the criteria below in Question #5 and is also looking to positively impact their organization by one of the following ways:

● Increase Net Revenue.
● Improve Payer Yield.
● Improve Payer Accountability.
● Reduce Future Underpayments.

Who’s not a good fit for a Zero-Balance Review?

Typically, we find that organizations with one of the following may not be a good fit for a Zero-Balance Review:

● Low-Patient Volume - Less than (1,000) discharges annually.
● High-Volume of Capitation - Over 75% of the patient volume is capitated.
● High-Patient Volume of Provider-Owned Health Plans - Over 50% of patient volume participates in provider-owned health plans that would be excluded from a Zero-Balance Review.

When will we begin receiving recoveries?

Typically, recoveries start coming in within 60-90 days of go-live.

Will Boost help our team get better & share process improvement ideas?

Absolutely, our clients typically see a ~35% reduction in underpayments over time due to process improvements & payers knowing that our clients are ‘fighting’ back for proper reimbursement.

What type of reporting will Boost provide?

Our executive-level and customized detailed reporting is designed to empower your team to better understand your payers, improve operationally, and reduce underpayments.

What’s needed from us to get started?

To get started, we need a data extract, your payer contracts, and access to your EMR/EHR.

Will our staff be replaced?

No, our Zero-Balance Review follows all existing internal efforts by reviewing accounts in a closed/zero-balance insurance status where no additional reimbursement is expected.

Does Boost operate as an extension of our team?

Yes, our team is an extension of yours as we pursue & recover underpayments on your behalf.

How much on-going support is needed from our team?

Very little and is only needed on 10-20% of the underpayments that we pursue due to their unique billing or coding needs.

Has Boost worked with our EMR/EHR?

Quite possibly since we have worked with many versions of Allscripts, Cerner, Epic, McKesson, Meditech, and many others.

Will Boost handle the appeal(s) and follow-up process?

Yes, our team owns the appeal and follow-up process with your payers.

How will my team know if Boost is working the account?

Depending on your EMR/EHR, we are typically assigned a “Billing Indicator” or “Agency Code” to identify accounts that we are pursuing for additional reimbursement.

What type of recoveries do Boost clients typically realize?

We conservatively expect our clients to recover an additional .25% - 1% of their annual net patient revenue per 12-months of data reviewed.

Example A ($250M NPR Health System) = $625K - $2.5M in annual recoveries.
Example B ($1B NPR Health System) = $2.5M - $10M in annual recoveries.

Will Boost share appeal letters?

Yes, Boost will gladly share successful appeal letters with our clients.
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Have More Questions?

Connect with our team of Zero-Balance experts and get your questions answered today!