Coordinated Care Organizations (CCO):
Healthcare transformation regulations will require CCOs to perform recovery audits and recoup overpayments from Medicaid and Medicare providers. The IBHI risk mitigation team can conduct audits on behalf of CCO's and their behavioral health provider network.
Behavioral Health Providers:
The IBHI audit team can perform a confidential risk assessment to assist behavioral health providers in assessing their financial risk. Technical assistance will also be provided to address any areas of risk identified in the audit.
Commercial Insurers:
IBHI is available to perform similar audits, as described above, under commercial insurance benefit plans.