White Paper

The Value of an Independent IME Review

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As a hospital leader, you want to ensure that your facility is properly reimbursed for all legitimate claims. IME billing is an issue worthy of your attention for a number of reasons. A complex system of multiple claim submissions (shadow billing) for Medicare Advantage inpatient acute discharges costs hospitals in the US well over $100-$160M. The continued year-to-year growth of Medicare Advantage enrollment only means that these costs will increase for all sized hospitals and systems. Even hospitals with established best practices around the shadow billing process may find that system conversions, updates, staffing changes and registration issues lead to missed shadow billing opportunities.

In this paper, you’ll learn:

  • Why the average hospital is missing from 5-8% of its shadow bills.
  • The specific reasons why underpayments occur.
  • The benefits of an independent shadow billing review.
IME white paper

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