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Cost containment

We are a recognized cost containment specialist, highly proficient in:

a. medical bill reviews and containment
b. claims re-pricing
c. seamless bill negotiation
d. out-of-area / out-of-network claims routing
e. negotiated discounts
f. medical audits

Elimination of duplicate invoicing

Our system records a history of all invoices registered as a claim and will alert our auditors and claims department when a provider charges for the same service on more than one occasion.

Multiple billing

This audit insures that a provider is not charging separately for several services that would normally be coalesced in a single procedure.

Utilization Review

Utilization is a significant part of cost containment. These procedures confirm that the duration of treatment for inpatient care and the number of visit being rendered to a patient is appropriate for the said diagnosis. All medical services are reviewed to ensure that they are appropriate for the condition that the patient is being treated for.

Medication Charges

All medication and suppliers are reviewed based on market value to include a reasonable mark up.

Case Efficiency

Case efficiency is a tool that is attractive to medical providers, insurance and assistance companies a like, as it entails a fast, efficient and effective turn over of medical claims, normally within a 24hr period.

Claim investigation

Case investigators involve at times possible fraud, incorrect or false reports being submitted for financial gain. This procedure limits the possibility of such claims and deters such actions due to the vigilance and consistency of our medical desk and auditors.]