Bill Review
Available nationwide, WellComp's medical bill review saves money for clients by
carefully reviewing and assessing charges according to state-mandated fee schedules and usual and customary rates.
We review all types of medical bills related to workers' compensation injuries. Our expert staff uses industry-specific
experience and continuous training to keep abreast of current workers' compensation law, understand rate precedents,
and meet clients' profitability needs. No bills are paid without proper written or verbal documentation.
In our experience, no detail of an accepted claim is as potentially time-consuming, complicated, or perilous as the
processing of medical bills. Proper payment for services can only be achieved through the coordinated effort of the claims
examiner, nurse manager, bill-auditing technician, and bill review software vendor. Unlike other bill review companies,
we use a combination of expert technology and "real people" scrutiny – a combination that we've found
produces the best results and the maximizes savings.
Customized Programs
Bills are checked for:
- Relatedness to a compensable condition
- Appropriateness under general billing practices
- Compliance with fee schedule values, ground rules, and consideration of reasonableness
We identify inappropriate billing patterns by:
- Maintaining close contact with the claims examiner so we know what to expect from the case
- Adherence to UR guidelines so inappropriate billings (or attempted billings) can be caught before they happen
- Consultation as needed with our Medical Director
Our effective bill review involves more than re-pricing to fee schedule and includes vetting out duplicates over
long periods, fighting for clients at settlement lien conferences, and gathering medical information.
Quantifiable Savings
Over the past six months, we have generated an average of 61 percent in net savings for our clients.
As our tracking and monitoring efforts substantiate, we consistently generate greater savings –
based on net charges and net savings – over other bill auditing software companies.