Medical bill review and processing
Our seamless methods include a detailed, manual review of every bill throughout the process to safeguard accuracy and deliver maximum cost savings.
Our 6 Step Bill Review Process
Codes We Identify
Double billing: for a procedure that has already been completed and billed (exact duplicates match all criteria including FEIN, date of service, coding and billed amount)
Unrelated procedures: separate from or not caused by original injury
Unbundling of billing codes: charge for two procedures, which are part of a single treatment
Quick Turnaround Response
All bills are reviewed within 3 to 5 days after receipt. If additional information is needed, the turn-around time may be extended. Rush service is available upon request (an additional fee will apply).
Pharmacy Benefit Management
Our Pharmacy Benefit Management (PBM) services evaluate drug usage, identify high-risk cases such as narcotic addiction and ensure approved, correct drugs are dispensed. We manage drug costs through an established prescription program partner that delivers our customers reduced contractual rates with pharmacists nationwide and provides assistance with prescription claim payments.
PPO Network Repricing
Access to nationwide Preferred Provider Organizations (PPO) networks is crucial to a successful managed care program. Innovative Risk Consulting has established partnerships with a wide choice of preferred provider networks throughout the country. We work closely with customers to select the best PPO network to provide discounted pricing that significantly lowers hospital and physician bills and maximizes savings.
Innovative Risk Consulting has established successful relationships with industry leaders for medical equipment, diagnostic services, transportation and translation, as well as home health, physical therapy and rehabilitation to bring additional cost savings to our customers.