AP-Companies - Cost containment

Our cost containment services are based on savings rather than discounts.

We define "savings" as any documented amount we successfully reduce or avoid throughout the case management process.

NEGOTIATED DISCOUNTS 35%

CASE MANAGEMENT 25%

COST CONTROL 25%

FRAUD INVESTIGATION 15%

Case management

Our case management services are designed to efficiently handle complex medical cases while optimizing costs. This includes:

Ongoing vigilance: Our in-house medical team provides vigilant monitoring of each case.
Hospitalization optimization: We work to streamline the number of hospitalization days whenever possible.
Timely evacuation and repatriation: When necessary, we ensure prompt evacuation and repatriation arrangements are made.

Negotiated Discounts

We achieve savings by negotiating discounts based on large volumes, local knowledge, an automated cost control system and active case management.

Cost control

Cost control is a powerful tool to reduce the costs of treatment that is already at the invoicing stage:

Automated cost containment tool
Bill audit
Standard deviation exercise approach to compare the prices for the same procedure in the facilities of the same level in the same area

Automated cost containment tool is used for claims management.

Upon receiving invoices, AP Companies' claims team employs an automated cost containment application for thorough scrutiny.
Technical checks are conducted to identify discrepancies such as duplicate submissions or price disparities.

Examples include detecting multiple submissions of the same invoice, identical services charged multiple times, and inconsistencies between listed prices and provider price lists.

Medical parameters are assessed to detect overutilization of services. This involves identifying excessive follow-up visits, prolonged inpatient stays, or unnecessary t esting.
Assessments are based on integrated ICD-10 and CPT-4 coding systems within our cost containment tool.
Since its launch our cost containment application has:
Enabled optimal savings.
Generated comprehensive statistics on provider utilization patterns.
Strengthened negotiation positions with providers.

With this tool, AP Companies ensures the highest level of cost control and containment procedures for our clients.

Fraud investigation

Fraud investigation includes provider validation, billing investigation, documents’ authenticity validation, cost validation and close monitoring of complicated providers.