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Our Members

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Recovery Audit Solutions, Inc. (RASI)

Tier 1 Member
(Founding Member)

Recovery Audit Solutions, Inc. (RASI) offers a broad range of pre-payment and post-payment claims auditing and compliance services. Our partnership and commitment is to analyze, validate, improve, and execute cost savings initiatives. Our payment integrity and compliance program values the bottom line and the importance of improving data insights that benefits our clients. 

WHY RASI?
 

RASI’s technology and proprietary algorithms coupled with our healthcare professional’s expertise have an established track record for accurate, ethical, and cost-effective reviews.  

 

  • Industry Experts: Medical doctors, nurses and/or certified coders

  • Results Driven: Solve payment integrity and compliance challenges

  • Change Rate: On average we find 7.4% change rate per claim

  • Accuracy Rate: 98.9% uncontested results

 

RASI understands that without turning data into information which in turn yields actionable insights, most efforts are incomplete.

REGIONS SERVED:
 

  • National

MANAGED CARE SEGMENTS / LINES OF BUSINESS SERVED:
 

  • Medicare

  • Medicaid

  • Commercial

  • Self Insurance

  • Third Party Administrators

PRODUCTS / SERVICES:
 

  1. Administrative Compliance Support: Perform analysis of prepaid and postpaid claims data based on contractual, policy and procedural standards. 

  2. Core Competencies: Our experienced staff has the technical knowledge and skillset to perform data analytics, audit and compliance reviews on all services and all claim types.

  3. Review Types: Includes but not limited to medical chart review, DRG validation, Outliers (extended inpatient stays), medical necessity of admission and appropriateness of billing.

  4. Personal Injury Medical Review Validation: Identify and validate accident-related medical services.

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