The Collaborative Credit Balance Solution
Credit balances are out of control. The only lasting remedy is collaboration; bringing payers and providers together to solve/prevent credits for good. And it’s finally possible with TREND.
payer considerations
By collaborating with healthcare providers, payers can more effectively recover and reduce overpayments.
$30M
Total amount a large health system can generate in new credit balances annually$5M
Amount an average sized provider can generate annually in new credit balances90 Days
Average age of unworked credit balance accounts$0
Up front cost to you. 100% risk free, contingency fee based on actual recoveriesCredit Balance Recovery
Credit balance recovery is a critical component of a mature payment integrity program at any payer. The identification of the claim overpayment occurs outside of the paid claims and eligibility data within the payer’s environment and inside provider data sets. 85-90% of all credit balance overpayments are not identified by the payer’s internal or vendor programs, thus credit balance recovery programs are the perfect supplement to any mature payment integrity program.Provider considerations
Through our collaborative approach, healthcare providers can resolve and prevent credits like never before.
Credit balances are costing you time and money and they don’t generate cash, but they have to be worked. TREND operates as an extension of your business office, leveraging TREND Connect to accurately & efficiently resolve credit balances.Credit Balances Impact on Healthcare Providers
Simply put, credit balances are a huge burden on healthcare providers. They strain resources and cash flow, all while increasing costs and risk. They must be resolved, but the status quo isn’t cutting it.
- Cash Flow Disruption
- Over-Refunding
- Increased Administrative Burden
- Compliance Risks
- Delayed Revenue Recognition
Why Use TREND for Credit Balance Resolution?
TREND can ease the burden of credits by delivering a configurable Credit Balance Resolution strategy and comprehensive reporting package that is unique to your facility.Reduce Costs / Reallocate Staff
Increase Net Revenue
Improve Contract Compliance
We work all credit balances, not just overpayments, and recover on behalf of our insurance payer clients as an extension of your business office. Our recovery analysts take ownership of their assigned accounts to bring them to an accurate and efficient resolution, as we maximize our value to you. You control the process. We ensure it is done efficiently and accurately.
Credit Balances Resolution is typically done at no cost to healthcare providers.
5+
Average years of credit balance resolution experience for a TREND recovery analyst30%
Average percentage of credit balances resolved via overpayment refund100
Average number of accounts worked per day by TREND recovery analysts$0
Upfront cost
100%
Risk free, contingency freeTREND has offloaded 165 FTE’s workload from providers, which could generate $570M in additional collections.
How It Works
1. Ingest Credit Balance Data
2. Analyze Credit Balances
3. Validate Findings
5. TREND Connect Resolution
4. Provider Review
Improving Outcomes With the First Credit Balance Solution That Brings Payers & Providers Together
Healthcare’s one-sided approach to credit balances in medical billing is making the problem worse. Backlogs are growing, teams are burnt out, and payers/providers are at odds.
Providers Process Fewer Refunds
Payers Stop Overpaying
By improving payment integrity, payers stop overpaying; meaning fewer resources are spent recouping dollars.
Healthcare Is More Efficient
The Problem
Credit Balances Are a Drain on Healthcare
Credit balances in medical billing are a costly reality that healthcare professionals see as “part of the job.” But operating under this paradigm has severe negative consequences.
Credit balances increase the cost of healthcare.
The time and resources improperly allocated to managing credit balances contribute substantially to the overall cost burden on the healthcare system. Inefficiencies caused by credit balances lead to higher operational costs for providers and payers alike, potentially resulting in increased service costs and higher co-pays, deductibles, or out-of-pocket expenses for patients.
Credit balances worsen the administrative burden on both payers and providers.
Identifying, investigating, and resolving credit balances require significant administrative resources from both payers and providers.
Credit balances damage payer-provider relationships.
Credit balances introduce financial discrepancies, increase administrative burdens, and foster mistrust; complicating contractual negotiations, creating operational inefficiencies, and deteriorating collaboration. To maintain strong relationships, payers and providers must address credit balances proactively, together.
Credit balances take your staff away from higher-impact activities.
Credit balances must be worked, but they require substantial resources and don’t generate revenue. TREND eases this burden by delivering a comprehensive credit balance solution so you can reallocate internal resources.
Credit balances negatively impact the patient experience.
Credit balances sometimes lead to billing issues that affect patients directly. And when patients are caught in the middle, it can damage both the provider’s and the payer’s reputation.
Credits Must Be Solved, and the Status Quo Isn’t Cutting It
75%
of credit balances are NOT the result of an overpayment
$35B+
in new credits are generated annually by healthcare providers
Other Vendors Choose Sides, We Choose Collaboration
This creates an unwinnable, never ending game of tug-of-war.
This kind of one-sided advocacy does little more than drive up costs and worsen outcomes for payers and providers alike.
The solution? To play on the same team, collaborating to extinguish the growing credit balance problem.
The Unified Credit Balance for Medical Billing Process
Ingest Data
Identify & Validate
Connect
Resolve & Refund
Report & Prevent
Team Payer vs. Team Provider
Team Healthcare
With TREND, payers and providers both win! By addressing the root causes of credit balances, healthcare can finally operate as a united front. TREND doesn’t play for “team provider” or “team payer,” we play for Team Healthcare.
1.9M
Credits Resolved
$1B+
Overpayments Identified
190
FTEs Offloaded
Technology
Powered by TREND Connectâ„¢
The platform allows healthcare providers to electronically submit self-reported overpayments back to connected insurance payers.
Claim details, applicable documentation, and specific recovery explanations are sent directly to adjusters for review and reconciliation.
Slash Labor Costs
Create an accurate audit trail
Comprehensive reporting
Payment Integrity
When Correct Payments Are Made, Credit Balances Disappear
More accurate payments reduce the need for refunds, reconciliations, and administrative corrections. As a result, credit balances are prevented and financial operations are streamlined.
RESOURCES
Navigating Credit Balance Complexities in Healthcare
Contract Vigilance: Valerie Thompson’s Strategy
Valerie Thompson, VP of Credit Balance Operations unpacks the challenges of false credit resolutions due to contract variances—a significant drain on resources.