ezURs can process your workers’ compensation or multi-line bills. ezURs.com uses technology along with skilled medical analysts and nurses to review medical bills. Our bill review programs can be seamless with any regional or national networks. Our Workers’ Comp bill review program uses highly sophisticated software systems, effective and efficient workflows, and a technically proficient bill review staff to deliver the most comprehensive and professional bill reviews available to workers’ compensation claims payers.
Through our aggressive bill review services, our clients consistently save in excess of 50% on medical bills.
We ensure maximum savings through measures including the application of fee schedules and billing ground rules; negotiation of fees whenever network discounts, state fee schedule reductions, or other appropriate review rationale are not available; and detection of improper billing practices and duplicate billings.
ezURs has access to all leading bill review software that provides a national rules-based bill review service with the flexibility and scalability to accommodate our clients’ needs. We apply the latest fee schedules, usual and customary rules, proprietary code-specific clinical edits, and automated provider network discounts. Additionally, our bill review system is integrated with our front-end processing operation to provide additional process efficiency and reduce bill turnaround time. Our front-end processing includes scanning, optical character recognition, formatting, storage, and the distribution and retrieval of all information required in the bill review process.
Through the automation of clinical judgment, evidence based guidelines; the bill review system achieves maximum results by:
- Applying fee schedules and billing ground rules, as set forth by the state, to take advantage of the best available discounts for our clients. ezURs.com receives regular software updates to ensure compliance with state regulations and fees.
- In states where no fee schedule exists, ezURs.com uses a database for medical, dental, outpatient facilities, inpatient facilities, anesthesia and Medicare’s Resource-Based Relative Value Scale (RBRVS) physician fee schedule, with the percentile of reimbursement customized to each client’s specifications or the industry standard.
- With the use of national coding and American Medical Association(AMA) and National Correct Coding Initiative(NCCI) broaden our results
- Duplicate and bundling and unbundling rules ezURs.com is able to find errors and duplicate bills.
- Integration with ezURs.com utilization review services and systems ensures reimbursement is made only for items approved in the treatment plan and which allow for automation of pre-authorized records
technology along with skilled medical analysts review medical bills
Medical Bill Review
ezURs brings additional savings to our clients by applying PPO contract discounts from national PPO network providers. We work with our clients to identify the best PPO network partners for their claims and work with them to optimize savings. All network discounts are applied after the bill is audited to the proper amount to ensure accurate savings.
Specialty Bill Review
We focus on resolving the more complex medical Workers’ Compensation claims or any other type of health claims resulting in tremendous savings of time and money for your company. Our clients are pleased with the additional dollars we are able to save and the reconsideration’s we eliminate.
Hospital Bill Review
On hospital bills, we complete quantitative and qualitative bill analyses, and review supporting documentation to ensure the charges are appropriate and accurate. ezURs applies proprietary re-pricing methodology to bills where applicable. Our audit services can also include the negotiation of high dollar bills to ensure costly charges are paid at the most reasonable rate possible.
Our in-house medical review negotiation team has demonstrated an effective solution for controlling non-network plan costs while maximizing savings, regardless of the chosen provider. Low dollar non-network claims are systematically discounted by means of a second-tier network.. We leverage our medical expertise, contractual relationships, repricing databases, veteran negotiators and expert coding review to provide the precision required to ensure you pay for only what’s right.