Find Out More!The Rodenhizer Group, LLC.
About Craig Rodenhizer and TRG
Craig Rodenhizer’s Story
“I was introduced to recovery auditing while working at The Travelers Insurance Company in Hartford, Connecticut in 1991. As a database specialist, I was often asked to assist business departments when they had data application problems. One day I got a fateful call to help a struggling Audit and Recovery Unit. Their job was to identify errant medical claims and recover resulting overpayments. Once I got a taste, I was hooked.
“I soon became their Director of Information Systems and headed the rewrite of a new overpayment detection and recovery system. The department went from recovering $100,000 per month to well over $1 million per month using the improved process.
“That project provided me with a completely new career perspective and led to a life-changing event. I realized it wasn’t good enough to be just a database programmer—in order to excel, I would have to learn the business from the ground up. To do this, I worked with David Guthrie, our best recovery auditor. We became best friends—almost joined at the hip!—and addicted to recovering money through data mining. I’m grateful to David to this day.
“In 1996, I left The Travelers to hang my own shingle. I met Ron Rogers, Director of Pharmacy Programs for the Minnesota Department of Human Services. Ron had credentials a mile long and was a wealth of information. He told me the Medicaid Drug Rebate Program was a mess. That was music to my ears! Ron and I spent the next several months developing a process that would help Medicaid agencies detect and correct errors in the prescription claims data so they could resolve disputed rebates.
“Kentucky Medicaid was our first client. We discovered $35 million in disputed rebates from 1991 through 1996. After correcting all the claim errors, we determined that $28 million of the disputes were justified, and we collected the remaining $7 million for our client.
“We snuck into that contract as a sole source vendor, but ‘the times, they were a-changing’ in government, and that wasn’t going to happen again. I didn’t want to deal with the cumbersome bidding process that was required of vendors, so I decided to jump the fence and work for the other side: the Drug Manufacturers. I quickly learned that many overcharges were missed and there were opportunities to recover duplicate or erroneous payments.
“Working for the pharmaceutical companies has been a great fit. I have had uninterrupted contracts with several major companies and have successfully recovered tens of millions of dollars in Medicaid, PHS, and other rebate overcharges.”
Interested in a consultation with Craig Rodenhizer? Contact Craig at:
The Rodenhizer Group, LLC.
Call (860) 346-5811 or
e-mail us.
