Bill Review/Repricing

 

Our bill review process ensures you only pay what is appropriate and correct!

 

Solin USA bill review services are designed to serve the Workers’ Compensation market. Workers’ Compensation fee schedules for all states, loaded into the system, ensure each bill is priced according to the applicable state fee schedule. In states without fee schedules bills are priced according to usual and customary charges for that area.

The system applies sophisticated checks for upcoding and unbundling of services, and identifies any duplicate bills. Procedure codes are reviewed to ensure they are appropriate for the condition being treated. Further checks confirm that services are causally related to the injury and the number of visits and duration of care are appropriate for the diagnosis.

The system covers inpatient, outpatient, pharmacy, DME and other medical bills.

  • National capability/available for all 50 states
  • Electronic data interface available to receive and distribute data
  • Adjusts bill allowances to reflect all state rules and regulations
  • Reprices bills to state fee schedules, U & C or PPO contract rates
  • Eliminates duplicate charges
  • Custom reporting available
  • Web based interface allows customers to review/print bills once repriced
  • Fast turnaround time
  • Experienced nurses are available to review bills that require special attention

 

Our sophisticated technology combined with customer flexibility and exemplary service makes Solin USA’s bill review unbeatable.