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Medical Claims Recovery Services Powered by Advanced Analytics

ERISA APPEAL SERVICES

RACMAX acts as a specialty forensic audit & compliance consulting partner to medical providers to appeal denied and underpaid healthcare claims for reimbursement.

We own a proprietary discovery analytics process to appeal denied or underpaid insurance claims under federal ERISA law as a patient advocate to recover more money than other firms.

While others may get you pennies on the dollar our recovery rates have exceeded 10-40% for some individual claims. 

We were the first to use this audit, compliance and legal solution to interrogate the hidden opportunity for medical providers nationwide. 

We offer you a proprietary process to appeal underpaid insurance claims under federal ERISA law as a patient advocate to get you more money for your unpaid bills.

 

 
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Maximizing Returns

RACMAX is bringing its audit, compliance and analytics expertise to optimize medical receivables.  Our recovery efforts are different from the traditional medical revenue enhancement firms.  We specialize in ERISA appeals that use the full extent of the law to enable much higher recovery rates.  

With our expertise, you recover more.

While others may get you pennies on the dollar our recovery rates have exceeded 10-40% for some individual claims. 

OUR role is to educate employers on the law, the rules and the consequences of inaction

It is NOT the provider contract that creates the obligation to pay, but it is the Qualified Health and Welfare Benefits Plan that obligates the payment and is the real contract.

ERISA Claim Appeals

We act as your virtual appeals department.  We will perform properly formatted, ERISA compliant, level 2 and above appeals. We manage all related communication and correspondence.  All funds are sent directly to you, we never have access to payments.  You only pay us once the monies are deposited in your account.

Provider Contract Review and Consultation

We have one of the largest databases of provider agreements across the country and our software allows us to compare and contrast your contract with many others.    From that we'll make recommendations to improve your standing with the carriers. 

Litigation Support

Frequently we are retained by litigation attorneys to perform Litigation Support to law firms on behalf of health care clients. This service can be requested by the health care provider or the lawyers.  Our services include research on ERISA claims regulations, exhaustion of administrative remedy and case review for similar circumstances. 
 

 

Contact us:

(312) 972-3929

info@racmax.com 

 

 

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ABOUT US

Our team has appealed tens of thousands of claims and retrieved millions of dollars for our clients nationally

RACMAX acts as a specialty audit and consulting partner to medical providers to appeal denied and underpaid healthcare claims for reimbursement. We offer you a proprietary process to appeal denied or underpaid insurance claims under federal ERISA law as a patient advocate to recover more money than other firms. We are the first to develop and use this solution and our clients are the first to reap the rewards from this hidden opportunity. 

Our leadership team is comprised of national healthcare CEO of major hospital systems coupled with expertise from both the Internal Audit and ERISA domains who (for over 30 years) have fought to expose the fraud, waste and abuse in the medical payment system and alike.  The experienced audit team employs scientifically proven artificially intelligent & machine learning capable software with a proprietary methodology to analyze and uncover the potential in your claim portfolio.  

This approach has been used at teaching hospitals, for profit hospitals, surgery centers and physician offices.  

“WE WILL REPLENISH YOUR BALANCE SHEET BY METHODICALLY REVIEWING RECEIVABLES THAT WERE PREVIOUSLY THOUGHT TO BE UNCOLLECTABLE” 

 

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Getting Started

Just transfer any claims that you have already attempted to collect on into our HIPAA compliant servers.  We can get started on filing the proper ERISA appeals today. Knowing the ERISA regulations, now augmented by PPACA regulations can increase your cash flow dramatically. Contact us right now to begin the discussion.

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Contact us:

Call (312) 972–3929

info@racmax.com