ADHC - Medical Underpayments

Access Discount Healthcare (ADHC) is a proprietary technology system that identifies and recovers underpayments, manages denials and overpayment fines and responses, automates appeals and requests, and is a contract modeler essential in negotiating more favorable contracts.

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ADHC funds all the costs and risks, including contract load fees, appeals processes, audits, and training which are applied to our recovery fee. Our fees are 100% paid by a percentage of the recovered underpayment fees from the initial audit of past claims.

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The Underpayment System historically uncovers 5-30% of commercial payments that have been paid incorrectly on every analysis. Our collection statistics for commercial payer underpayments are 85-90% of identified claims. Most contracts allow providers to appeal claims that have been underpaid or paid incorrectly for up to 12 months from the last response by the insurer. After 12 months, they will expire, at which point you can never bill or collect. Our system recovers additional underpayments owed on zero-balance accounts. Dollars underpaid after EMR/EHR and billing systems have fully processed claims as “PAID IN FULL.”

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The minimum facility time is 30 minutes or less to upload 835 electronic billing records through our proprietary encryption platform, which uses the highest HIPAA standards. Once we have received all contracts and data files, it typically will take 3 or 4 weeks to complete the analysis and start the appeals process.

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Every situation is different. Our program delivers industry-leading results, added value analytic and support data, and in most cases, we deliver double the industry standard in data and payments.