Cost Avoidance

HMS understands the importance of accurate, timely cost avoidance data for healthcare programs. By discovering new coverage information, HMS clients avoid paying future claims, resulting in savings worth many times the value of payments recovered retroactively through typical "pay and chase" activities.

By matching Medicaid eligibility files to our database of national insurance eligibility information, HMS locates other available coverage. We then verify coverage directly with the carrier through a combination of online tools and telephone contact. Equipped with this information, Medicaid agencies can ensure that they are the "payor of last resort" and avoid paying for services for which another party is legally liable.

As the national leader in cost avoidance, HMS has identified and verified millions of previously undiscovered insurance policies, resulting in billions of dollars in savings annually to our clients.