The Company
The Assist Group has leveraged technology, clinical and industry experts to develop the next generation of claims management solutions that take a complete view of the claim – clinical and financial. Founded in 1999, we are the leader in integrated claims review and resolution for catastrophic claims. Since the very beginning, our goal has remained the same: To provide our clients with consistent, supportable findings and measurable savings to their payable claims. Our proprietary process allows us to reconstruct the clinical course of care to identify improper payments and errors.
The Assist Group specializes in catastrophic facility claims (greater than $50,000 payable), prior to payment.
The Challenge
- An HHS/CMS Annual Healthcare Spending Report estimates an annual $87.7 billion of the national outlay for facility care is lost to improper payments
- According to the General Accounting Office (GAO), 99% of hospital bills contain overcharges including:
- Incorrect DRG Assignment
- Unbundling/Upcoding/Billing errors
- Level of care not consistent with acuity of care
- Experimental therapies
- Quality of care issues -- never events, hospital acquired conditions (HAC), medical errors and iatrogenic events
- Gaps between billed charges and care rendered
- Complex catastrophic facility claims require a hands on approach
The Assist Group's Solutions
ClinAssist
It is estimated that more than 80% of hospital claims contain significant errors. ClinAssist is the leader in complex claims review and resolution. We offer payers a complete solution: initial screening through settlement. ClinAssist delivers a significant return on investment, yielding an average savings of 21.1%.*
CareAssist
The combined cost of maternity, newborn and pediatric care is one of the most significant for health care payers. CareAssist is a care management program designed to positively impact clinical and financial outcomes for maternity, complex newborns and pediatrics.
