Case Study: a major U.S. health plan achieves over $1.2 billion in credit balance recoveries with Conduent

Managing credit balances for a major U.S. health plan and generating millions in annual recoveries

A major U.S. health plan with over 40 million members was missing out on millions of dollars in overpayment recoveries annually. Realizing it would be cost-prohibitive to build an internal solution across the more than ten states in which it operated, the health plan chose Conduent to manage its credit balance research and recovery efforts.

Conduent leveraged its extensive network of provider relationships and its proprietary Credit Balance Analysis System (CBAS) to identify and recover overpayments. This process moved the client from ambiguous data mining to targeted on-site reviews. Over a 17-year partnership, Conduent audited over 700,000 claims and generated more than $1.2 billion in recoveries for the health plan, surpassing recovery goals each year.