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Forensic Analysis, Paying, Pricing & Analyzing Claims


Find out why Payers, TPAs, Case Managers, IPAs and MSOs should attend

The ADJUDICATION SEMINAR is a two (2) day workshop about scrubbing claims, analysis of overpayments, underpayments, waste, fraud and abuse. It is about forensic analysis of claims and cost containment. The seminar covers implementation of coding techniques paying claims and pricing services.

The Managed Care section of the workshop teaches how to detect overcharges in member services, funding, professional and institutional claims as well as in pharmacy charges. Also we demonstrate how to prepare claims contestations.

The implementation of the claims processing modalities discussed in the workshop represent the most vital tools in cost containment for payers and TPAs in adjudicating claims and for IPAs and MSOs in analyzing claims paid and distributions rewarded by HMOs. Millions of dollars can be saved!

Also the Adjudication Seminar can simplify the job of Case Managers estimating claims of services rendered by providers that are considered “out-of-network”.

Pricing services and structuring agreements with managed care plans, specialists, diagnostic and ancillary services providers are essential components in controlling cost and improving the quality of care. In the workshop we address pricing and contracting services.

The discussion about claims scrubbers explains the basic rules in analyzing claims, our HPP AccuChecker team has developed seven (7) claims scrubbers systems in the last twenty years – we learned that you can develop a claims scrubber in 60 to 90 days if you have a team of programmers and healthcare reimbursement experts working together.

31 years of experience processing and analyzing claims plus over 500 Medicare and Medicaid audits have given us the knowledge and background to introduce measures to detect and control UNDERPAYMENTS, OVERPAYENTS, WASTE, FRAUD and ABUSE.


HPP Management Group, Corp.

Developers of the AccuChecker Product Line

Phone: (786) 574-4560