 | |
| Company type | Private |
|---|---|
| Founded | 1979, USA |
Key people | Libby Connolly Alexander, CEO |
| Website | www.Connolly.com |
Connolly, LLC (formerly Connolly, Inc.) is a private, global-recovery audit firm with more than 1,200 employees, and two divisions Global Retail and Healthcare. The company is headquartered in Wilton, Connecticut. [1]
Recovery auditing involves recouping the money that companies and government agencies have erroneously paid to suppliers, vendors, and providers. These errors can include duplicate payments, missed discounts, and incorrectly coded medical claims. [2] These types of improper payments are endemic to most large organizations and can range from less than 1% to as much as 8% of expenditures. [3]
Connolly was founded in 1979 by James Connolly, a former executive at the Gimbels department store, and was initially known as Connolly Consulting Associates. The company’s initial focus was on retailers, but the business was expanded to non-retailers in the early 1990s, and to healthcare medical claims auditing in the late 1990s. Larry Connolly assumed leadership of the company in 1991, retiring in 2012. Libby Connolly Alexander is the CEO. [4]
Connolly’s Healthcare Division serves commercial and government payers in the identification of erroneous healthcare claims. The company has also worked for the Centers for Medicaid and Medicare Services (CMS) as a Recovery Audit Contractor (RAC) [5] since 2005.
Connolly’s Retail Division serves 19 out of the top 20 U.S. retailers. [6]
The False Claims Act of 1863 (FCA) is an American federal law that imposes liability on persons and companies who defraud governmental programs. It is the federal government's primary litigation tool in combating fraud against the government. The law includes a qui tam provision that allows people who are not affiliated with the government, called "relators" under the law, to file actions on behalf of the government. This is informally called "whistleblowing", especially when the relator is employed by the organization accused in the suit. Persons filing actions under the Act stand to receive a portion of any recovered damages.
The point of sale (POS) or point of purchase (POP) is the time and place at which a retail transaction is completed. At the point of sale, the merchant calculates the amount owed by the customer, indicates that amount, may prepare an invoice for the customer, and indicates the options for the customer to make payment. It is also the point at which a customer makes a payment to the merchant in exchange for goods or after provision of a service. After receiving payment, the merchant may issue a receipt, as proof of transaction, which is usually printed but can also be dispensed with or sent electronically.
The Health Insurance Portability and Accountability Act of 1996 is a United States Act of Congress enacted by the 104th United States Congress and signed into law by President Bill Clinton on August 21, 1996. It aimed to alter the transfer of healthcare information, stipulated the guidelines by which personally identifiable information maintained by the healthcare and healthcare insurance industries should be protected from fraud and theft, and addressed some limitations on healthcare insurance coverage. It generally prohibits healthcare providers and businesses called covered entities from disclosing protected information to anyone other than a patient and the patient's authorized representatives without their consent. The bill does not restrict patients from receiving information about themselves. Furthermore, it does not prohibit patients from voluntarily sharing their health information however they choose, nor does it require confidentiality where a patient discloses medical information to family members, friends or other individuals not employees of a covered entity.
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The Home Depot, Inc., sometimes referred to as Home Depot, is an American multinational home improvement retail corporation that sells tools, construction products, appliances, and services, including fuel and transportation rentals. Home Depot is the largest home improvement retailer in the United States. In 2021, the company had 490,600 employees and more than $151 billion in revenue. The company is headquartered in unincorporated Cobb County, Georgia, with an Atlanta mailing address.
The Recovery Audit Contractor, or RAC, program was created through the Medicare Modernization Act of 2003 (MMA) to identify and recover improper Medicare payments paid to healthcare providers under fee-for-service (FFS) Medicare plans. The United States Department of Health and Human Services (DHHS) is required by law to make the program permanent for all states by January 1, 2010, under section 302 of the Tax Relief and Health Care Act of 2006.
Allison Engine Co. v. United States ex rel. Sanders, 553 U.S. 662 (2008), was a decision by the Supreme Court of the United States holding that plaintiffs under the False Claims Act must prove that the false claim was made with the specific intent of inducing the government to pay or approve payment of a false or fraudulent claim, rather than merely defrauding a contractor. Congress overruled this decision with the Fraud Enforcement and Recovery Act of 2009.
Omnichannel is a neologism describing a business strategy. According to Frost & Sullivan, omnichannel is defined as "seamless and effortless, high-quality customer experiences that occur within and between contact channels".
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Recovery auditing is the systematic process of reviewing disbursement transactions and the related supporting data to identify and recover various forms of over payments and under-deductions to suppliers. In other words, it is the recovery of lost money.
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