Aug 6 2009
HMS today announced that it had been awarded a contract by the West Virginia Public Employees Insurance Agency (WV PEIA) to perform provider credit balance reviews. The West Virginia Children's Health Insurance Program and AccessWV, the State's high-risk insurance coverage, will be joining with PEIA for these activities.
WV PEIA provides health and life insurance benefits to more than 200,000 active and retired public employees and family members. Its healthcare finance plan for fiscal year 2010 included increases in members' monthly premiums; HMS's services are expected to assist the agency in controlling rising healthcare costs.
HMS's approach to credit balances integrates a variety of overpayment identification processes--including professional and facility provider on-site audits, targeted claim analysis, and medical records reviews. HMS will identify the root causes of credit balance overpayments and work with providers to implement corrective actions, reducing future overpayments by PEIA.
In addition to serving WV PEIA, HMS provides a range of coordination of benefits and program integrity services to the West Virginia Department of Health & Human Resources, and to the West Virginia Children's Health Insurance Program.
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