Managed Care Reviews


Discover where your contract underpayments are hiding.

Healthcare providers are constantly modifying their contract management processes to ensure that contracts are accurately paid. At NHR, we frequently find hospitals unintentionally accept payor underpayments due to the complexity in modeling today’s reimbursement formulas. Inaccurate managed care payments usually result in lost revenue to hospitals.

NHR’s intensive payment review programs are designed to discover incorrect payments that normal processes fail to identify.
Our Services

The breadth of experience and diverse backgrounds of our professional staff affords us the opportunity to offer a wide range of clinical-financial auditing solutions that include:

Charge Capture Reviews
Charge Description Master Reviews
Insurance Defense Audits
Coding Services
RAC Defense & Education Program
Appeals & Denials
Managed Care Contracting
Managed Care Reviews
  • Comprehensive audit of all payor payments
  • Review contract verbiage that affects reimbursement
  • Verification of CPI escalator payments
  • Follow-up and collection of underpayments
  • Client reports in a format that easily identifies causes and facilitates corrective action
  • Client education programs tailored to address specific audit findings
For more information, contact us: info@nhri.com
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