Performed after claims are adjudicated but before they’re paid, our high-dollar bill review service audits select claims to proactively and substantially reduce bill totals and prevent unnecessary revenue loss.
Beyond these immediate benefits, our high-dollar bill review also delivers long-term benefits to your plan by uncovering flaws in your claims processing, often resulting in improved provider contracting processes and billing practices.
- Utilizes our proprietary algorithms to identify claims that the payer can deny at the line item on a pre-pay basis
- Reviews contracted and non-contracted inpatient claims paid at a percentage of billed charges
- No medical records required