The majority of the complex and specialty bills are the highest dollar bills. These are not repricable only by utilizing bill review software engines. They require medical necessity evaluation by a qualified clinical team supported by evidence based guidelines. We provide this specialized and highly technical service to support our bill review service.

• Evaluation of Medical Necessity for services provided
• Evaluation of Over Utilization of services
• Evaluation of Appropriateness of Procedures
• Evaluation of Appropriateness of Billing Methodology
• Evaluation of Compliance with Rules and Regulations

• Specialty Medical Team
• Specialty Nursing Team
• Specialty Bill Review Teams
• Evidence Based Guidelines
• Medical Bill Review Fee Schedules and State Specific Rules and Regulations
• Advanced Bill Review Software

• Medical Bill Analysis and Reports
• Bill Payment Recommendations
• Evidence Based Guidelines
• Expert Witnesses