Medical Bill Review
What we do
We help self-insured employers, TPAs, and insurers save money by providing medical bill review services while utilizing our own direct contracts with our home-grown preferred provider network.
We work with you to determine the best solutions to mitigate your workers' compensation costs. For instance, if you already use a provider network, we would provide a free cost analysis using a current loss run which will illustrate where you will see additional savings, or we would suggest being layered in as a secondary or tertiary tier to capture additional savings.
Because we remain focused on these key services, we can operate faster, respond to urgent requests, offer administrative support, and provide exceptional customer service.
We work with you to determine the best solutions to mitigate your workers' compensation costs. For instance, if you already use a provider network, we would provide a free cost analysis using a current loss run which will illustrate where you will see additional savings, or we would suggest being layered in as a secondary or tertiary tier to capture additional savings.
Because we remain focused on these key services, we can operate faster, respond to urgent requests, offer administrative support, and provide exceptional customer service.
Our Bill Review Program Includes
- Extensive coding review and repricing
- State fee schedule and law adjustments
- Usual, customary and reasonable review
- Proprietary contractual rates with preferred WC providers
- Negotiated caps on medical bills for cost containment
- Utilization review flags
- Examination for duplicate billings/unnecessary charges
- Provider Payment solutions
- Client Web Portal for reports access
Consulting Services
We recognize that our success depends on providing truly customizable solutions that help you achieve maximum savings. Capitalizing on both new technology and the expertise of our team allows us to deliver more value to your current programs in place.
Since 1994, our focus has been to provide results-based services and build a network of healthcare professionals that seek to deliver quality care to injured workers within our community at a reasonable cost for employers, while providing unmatched customer service and administrative support to those TPAs, Insurers, Self-Insured Employers and Self-Insured Groups.
Data Structuring
Our expertise reaches various fields to provide value to our clients where they need it most. Our knowledgeable staff works directly with clients on solutions for their claims systems, reporting, implementation of new programs and/or software, and data management, giving our clients options that could benefit their workflow processes and alleviate staff hours on inefficient tasks and additional projects.