Inpatient and Outpatient Programs

Inpatient and Outpatient Contractual Underpay Programs

Per RTR’s team-centric philosophy:

• Each referral will be grouped by Insurance Carrier and assigned an Insurance Carrier Specific team
• Each line CPT code will be audited and reconciled with the Carrier Contract as to establish an itemized reimbursement projection.
• The itemized reimbursement forecast is than applied to the Carrier Explanation of Benefits as to ensure and defend all reimbursement.
• All services paid will be reconciled, applied to the relevant facility contractual reimbursement and corresponding metric department to update contractual issues.