When hospitals, physicians or other qualified personnel provide services to an injured worker, their charges are subject to state mandated guidelines under the workers' compensation system.

We operate our in-house Bill Review service primarily in conjunction with our First Aid Programs for our clients.

• We take the bills generated for the services provided as First Aid to an injured worker, review the charges for accuracy and adjust the rates according to the state mandated fee schedule (SMFS) for occupational injuries.
• We also apply any Preferred Provider Organization [PPO] discounts available (60% of all bills will "hit" PPO networks and qualify for some amount of further discount. These bills actually end up negotiated far below the SMFS).
• We present the revised bill to our clients for payment.

Claims Billing Consulting

When escalated billing issues occur within their workers' compensation insurance program, our Bill Review professionals are able to provide specialized consultation to our clients. Areas of consultation typically include: incorrect billing, inaccurate coding / amounts, provider network contracts, understanding / applying fee schedules and maximizing allowable discounts.