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ICCMRinc - Integrity Clinical Claims Review, INC

Our primary focus will be supporting your business on proper administration and adjudication of healthcare benefits and claims. 

 

ICCMR, has an integrated, risk-based approach to delivering exceptional services to our clients. Trust, integrity, and commitment to excellence are the foundation of our exceptional client service approach. 

About

 

 

Our Southern California auditors are healthcare and managed-care specialists with over 25 years of experience. They'll spend less time learning your business and more time looking for your money. They know what to look for and what data to test.
Our people include coders, clinicians, healthcare reimbursement experts, statisticians, and programmers.

Claims

 

 

Claims audits need to be performed routinely to ensure that a plan’s claims payer has adequate controls in place to effectively administer the plan and pay claims in a timely and accurate manner. Under a self-funded arrangement, plan sponsors, not insurers, assume the risk. An ongoing claim audit program not only enables plan sponsors to satisfy their fiduciary obligations, but also to monitor costs and potentially identify areas for savings.

Clinical Reviews

 

 

Governmental payors have put reimbursement recovery measures into place with the Recovery Audit Contractor (RAC) Audits which are putting a significant amount of reimbursement at risk. Medicare Severity-Diagnosis Related Groups (MS-DRGs) have posed another obstacle for providers, many of whom are facing the possibility of declining Medicare reimbursement. Additionally, ICD-10 has created an unstable landscape as physicians and coders adapt to new documentation standards and coding guidelines.

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