Medical Bill Review & Repricing
Our team ensures our clients pay the lowest available costs for Medical Services by offering a suite of medical review services to create a complete savings solution. Our in-house team offers:
Experienced Bill Reviewers identify questionable diagnostic codes, procedure codes and bills requiring additional review
Experienced Registered Nurses for consultation and negotiation
Savings analysis reports that demonstrate best in class savings to our clients
Industry leading technology
Access to multiple PPO networks including ancillary networks
Utilization Review
Our medical review services also include nurses who are experts at reviewing medical reports and corresponding bills. Their in-depth evaluation identifies appropriateness of care, relatedness to diagnosis, frequency and duration of treatment. Eliminating excessive charges leads to cost containment and reduces medical costs for our customers.
PPO Networks
Use of PPO networks results in additional savings to our clients beyond fee schedules and beyond usual and customary prices.
Pre-negotiated contractual savings
PPO discount applied during bill repricing process
Names of out-of-network providers may be submitted for solicitation to join PPO
Employers may choose to use listing of PPO members to direct care
Pharmacy Direct Pay PPO service available