Featured Case Study
Insurance Carrier Billing Dispute
A CME client was involved in a billing dispute with a large insurance carrier. By the time CME was notified, the dispute had grown in excess of $917,000. This amount had been developing over years and CME determined that it would be both difficult and time consuming to reconcile accurately. After working with both parties to identify the full scope of the problem, as well as possible solutions, CME arranged a meeting with the carrier and the client. As a result of CME’s research, recommendations, and ongoing business relationship with the carrier, the disputed difference was reduced by over $433,000. This not only saved the client $433,000, but also the countless hours they would have needed to reconcile the accounts if CME had not been able to broker this agreement. As part of the agreement, CME also negotiated for the carrier to both accept a monthly electronic file from the client and reconcile that data with their own system, so that any discrepancies could be handled immediately. Accordingly, the client and the carrier’s eligibility and billing are now in sync and future discrepancies will be better resolved with ease and efficiency.