We offer broad data mining analytics that target claims based on recognized industry issues, payer-specific weaknesses, coding and billing rule changes, or other areas identified from our experience. Examples of data mining categories include:

  • Provider billing and coding
  • COB and eligibility
  • Contract compliance reviews
  • System limitation benefits and policy rules
  • Special services reconciliation
  • Medicare, Medicaid, and Duals compliance

Data mining uses a combination of algorithms and statistical analysis to rapidly identify claims that are most likely to include errors. Our solution takes advantage of the Performant Insightâ„¢ technology to accelerate error identification and also predict future sources of errors.

Talk to us to learn more about our library of data mining algorithms.

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