Advanced Medical Strategies (AMS) is the premier provider of payment integrity, risk management, and business intelligence solutions to identify and address excessive claims, prevent and recoup overpayments, and effectively manage the risks associated with high-cost claimants and group health underwriting.
Leveraging data analytics and advanced investigative tools to uncover potential FWA
Demonstrating the value of predictive modelling in targeting suspicious providers and claims
Coordinating the efforts of credentialing/enrollment, audits, investigations (SIUs), provider sanctions, and policy
Very few insurance payers have all those groups working together in a coordinated effort to reduce fraud, increase revenue, and render excellent customer service to enrolled health care providers.
Importance of accurate and complete clinical documentation
Addressing common coding challenges and complexities faced by providers,
Driving revenue integrity with a robust CDI program
Details TBC
