Products & Services: Medical Bill Review

Real Savings.

Advanced technology.
Expert review.
Personal service.

While many TPA’s outsource medical bill review, Salus’ in-house team of experts work hand-in-hand with our claims team and our customers to ensure accurate and appropriate payment for medical services.

Our industry leading bill review software is integrated with our claims system. This comprehensive system:

  1. ingests and adjudicates medical bills
  2. prices bills to state mandated fee schedules or usual and customary rates
  3. ensures that negotiated provider discounts are applied
  4. detects and eliminates duplicate billings, and
  5. denies payments for unauthorized services.

Our advanced, customizable rules engine allows straight-through processing of bills or, when appropriate, routes bills for expert review to our senior auditors, who in-turn, refer complex hospital reviews to trained clinicians when appropriate.

Our combination of state-of-the-art systems, hands-on experience, and advanced data analytics enables Salus to adjudicate negotiated rates and eliminate payments for duplicate and unauthorized bills.


Features and benefits


At a glance

SAVINGS

60%   Average, defensible net savings

RETURN ON INVESTMENT

1,880%   For every dollar spent on bill review

TURN-AROUND TIME

< 3 days   Faster than state mandates 98% of time

DISPUTES

< 2%   results questioned by originating provider

 

Contact us

Ready to partner with the workplace injury expert?

1-800-597-1690