Introducing TRENDSubmit: A New Provider Self-Reporting Process for Overpayments

Federal and state regulations require providers to routinely audit claims for overpayments. To meet this requirement, providers must notify Highmark Wholecare in writing of the reason for the overpayment and return the full amount of the overpayment within 60 days of the date they identified the overpayment.

Providers can now electronically submit overpayments via TRENDSubmit. This secure, online process allows providers to be notified of claim retractions in real-time and eliminates the lengthy manual paper process. Historically, providers have had to complete and submit the Provider Self-Audit form that is located on the Highmark Wholecare Provider Resource Center to complete this process.

Providers can contact Lauren Smith (lsmith@trendhealthpartners.com) to initiate TRENDSubmit access, receive user training resources, and get ongoing support.

The benefits of TRENDSubmit include:

• Reduction in Business Office Administrative Costs – Eliminates the lengthy and costly manual or paper process.
• User-friendly, Simple Approach – Secure, online process with capability to electronically attach supporting documentation. Additionally, the system offers streamlined point and click navigation with minimal keystrokes.
• 100% Accountability – Direct communication between Payer and Provider and real-time overpayment status updates.
• Comprehensive Reporting – Access to dashboard reporting around submission status, productivity, and root cause analysis. Additionally, the system shares full visibility and tracking of overpayment from submission to retraction.

If you have any questions regarding Provider Self-Audits, you can contact Highmark Wholecare’s Special Investigation Unit (SIU) at ProviderSelfAudits@HighmarkWholecare.com.