Company Profile
Through a combination of error and abuse in the system, many healthcare payers are substantially overpaying claims. This is especially true in high risk areas that include implantable devices and high cost drugs.
Waymark Associates helps our clients identify overpayments on current high risk claims as well as recognize and prevent billing inaccuracies on future claims. We provide services to a national client base of healthcare payers that includes insurance companies, Third Party Administrators, unions and others.
Based in Shelton, Connecticut, Waymark Associates is led by a management team with more than 35 years of combined healthcare experience. We provide our clients with:Expert analysis of claims data
Using proprietary data analytics tools, we identify large “one-off” overpayments that can be quickly pursued with little, if any, review of supporting documentation or dialogue with providers. We also pinpoint different situations that justify more extensive auditing through an “on-site” or “desk” review.Comprehensive auditing services
Our unique approach to auditing services combines two practices. First, we review supporting medical records to identify common overpayments and billing for services not provided at all. Second, we review your plan’s payment policies, provider contracts and related documentation to identify overpayments due to provider exploitation and manipulation of your company’s internal processes.Strategic consulting services
Waymark Associates’ strategic consultants will assist your company in developing practices and procedures designed to minimize claims overpayments both now and in the future. Our strategic consulting services include• improving payment policies
• provider fee methodologies
• claims processing procedures
• provider contract language
• audit design and overpayment recovery.
Collection assistance
We can assist in the recovery of excessive funds paid out by your company to settle claims. This can range from end-to-end collection services to providing support for your existing collections team and efforts.
The Value We Deliver
WayMark Associates can immediately help your company improve its bottom line by reducing claims costs at a significant return on investment. We offer highly flexible programs – combining components that are fee-based as well as contingency based (“self-funding” where we’re paid out of monies recovered) – designed to best meet your company’s requirements.
