Success in Detecting Errors and Overpayments
HDMGS’ innovative solutions lead the industry to detect claim errors and overpayments. We utilize electronic data mining tools and analysis to determine whether contractors and health care providers are accurately adhering to contractual obligations, regulations, industry coding practices, benefits coverage, and financial agreements.

HDMGS has created innovative detection methods to uncover the widespread growth in improper billing and payments. Improper payments may include the following:

• Inadvertent errors, such as duplicates and miscalculations.
• Payments for unsupported or inadequately supported claims.
• Payments for services not rendered.
• Payments for non-covered services.
• Payments to ineligible beneficiaries.
• Payments resulting from outright fraud and abuse.
• Other party liability and coordination of benefits.