Medical Bill Review
It’s virtually inevitable: at some point, nearly every company faces workplace injuries and must address complicated workers’ compensation issues. Often the sheer volume of mandatory paperwork, reports and billing statements can make it difficult to monitor medical and rehabilitation costs in an efficient manner. Our bill review partner will ensure that you pay only what you owe. We specialize in reviewing your medical expenditures, pursuing favorable negotiated rates and ensuring reasonable resources for worker recovery.
We've Got It Covered
Our medical bill review system is integrated to include all elements of medical cost containment, including review of bills to regulatory fee schedules, medical/disability management recommendations, claim system integration and automated management reporting. All of these capabilities enable us to take a highly detailed, thorough approach to justifying each and every medical expenditure you make.
A Proactive Approach
In addition to standard reductions, our Plus service gives you more. Should an inpatient, ambulatory surgical center or outpatient facility service be rendered by a non-participating provider, our staff of highly skilled nurses will initiate the fee negotiation process. We will research all available network discounts and negotiate fair rates with the provider.
We put the Web to work by offering SmartView, which provides a "window" into the bill review process. This web-based portal gives the user access to information regarding bills that have been submitted for review. It can also provide access to extensive historical information, including explanations of review (EOR), sendbacks, reconsiderations and more. It’s all done over the web, from any Internet-enabled computer, with 128-bit encryption to ensure maximum security. Keeping tabs on workers’ compensation has never been easier.
Medical Bill Review Services Include:
- Physician, hospital/facility, medical/legal, and pharmacy bill review
- Enforcement of medical/disability management recommendations
- Provider appeals
- National PPO network coverage
- Fee negotiation
- Mandated state reporting
- Optional services
- PBR Plus Service
- Traditional mail-in service bureau
- Imaging/OCR/Electronic bill submission
- On-site bill review services