DATA MINING & RECOVERY
Find What Others Miss.
Even the most mature payment integrity programs can’t see everything.
Trend’s Data Mining & Recovery solution uncovers overpayment patterns and recovery opportunities that sit beyond traditional payer analytics and existing vendor programs, delivering incremental, accurate recoveries without disrupting the payment integrity ecosystem already in place.
What Is Healthcare Data Mining for Payment Integrity?
Healthcare data mining uses claims and related data to identify patterns that may indicate payment inaccuracies and overpayments.
Trend takes that analysis further, looking beyond traditional paid-claims and eligibility logic to uncover complex patterns across payers, providers, policies, and outcomes. The result is an incremental layer of overpayment identification designed to complement existing payment integrity programs, not duplicate them.
More Signals, Not More Noise.
Payers have invested heavily in payment integrity, from prepay edits and internal analytics to multiple post-pay recovery vendors.
But adding more rules to the same data doesn’t necessarily create greater visibility.
Overpayments can remain hidden in complex claim scenarios, policy interpretation differences, changing provider behaviors, and patterns that only emerge over time or across different environments.
The opportunity isn’t simply to look harder.
It’s to see differently.
What Makes Trend Data Mining Different?
Trend brings visibility across both payer and provider environments, creating a broader view of payment behavior and helping surface patterns that conventional payer-only analytics may not reveal.
That cross-environment intelligence allows Trend to extend the reach of existing payment integrity programs into areas that are structurally difficult to see.
Built to Complement Mature Payment Integrity Programs
You need incremental value.
Trend Data Mining is designed to work alongside existing internal teams, analytics, and payment integrity partners, focusing on concepts and recovery opportunities that fall outside existing scopes.
No unnecessary duplication.
No volume for volume’s sake.
Just additional signal your program can act on.
Why Payers Choose Trend
Trend prioritizes accuracy, insights, and prevention over recovery volume, helping reduce false positives, unnecessary provider abrasion, and downstream rework.
Cross-Environment Intelligence
Understanding across payer and provider environments helps uncover patterns that a payer-side only perspective cannot surface.
Validation Before Recovery
Glass-Box Methodology
Findings are accurate, explainable, and grounded in payer policy and adjudication logic, not black-box scoring.
Designed for Any Pass
How Trend Approaches Overpayment Identification
Discover
Validate
Recover
Strengthen
Intelligence Applied to Complex Payment Integrity Challenges
Trend’s Data Mining approach extends across complex payment integrity areas where traditional claims logic and existing vendor models may leave opportunities unidentified.
Coordination of Benefits
Find coverage responsibility that doesn’t align.
Trend identifies overpayments associated with incorrect or incomplete coordination of benefits, including situations where other coverage exists but wasn’t appropriately applied or primary and secondary payer responsibility is misaligned.
Findings are validated against eligibility, enrollment, and COB requirements before recovery opportunities advance.
25-35% Lift in Recoveries
Reduced Vendor Overlap
ESRD Identification & Recovery
Uncover inaccuracies hidden inside complex Renal claims.
End-Stage Renal Disease claims create a uniquely complex payment environment. Trend analyzes renal claims for a range of potential overpayments, including Medicare/commercial payer responsibility, ESRD status and eligibility issues, as well as rate-related and contractual pricing discrepancies. Potential opportunities are then validated against applicable payer rules, eligibility timelines, and reimbursement requirements.
5–10% Classification Error Rate Identified
$200K–$1M Recovery Per Audit Cycle
Recovery Today. Better Accuracy Tomorrow.
Aggregate findings can reveal broader patterns behind payment inaccuracies, helping payer organizations better understand:
Recurring overpayment patterns
policy and adjudication variance
systemic sources of payment leakage
opportunities for expanded concept discovery
areas for future overpayment prevention
Because the long-term opportunity isn’t simply recovering more – it’s preventing more inaccuracies from happening in the first place.
What is data mining in healthcare payment integrity?
Does Trend replace our existing payment integrity vendors?
How does Trend reduce false positives?
Is Trend's Data Mining a black-box analytics solution?
“Trend Health Partners stepping in and actually being on-site to explain what is happening is reducing a lot of the provider abrasion at this time.”
– Manager, August 2026