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

Get Started with on-site or telephonic Nurse Case Management

Want to learn more about the services and solutions we offer? Get in touch, our team will help you get started.