Medical Bill Review
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Bill Review Overview
Bill Review is not just a data entry transaction at Definiti. Our primary focus is to deliver the “Best Net Value” while maintaining superior level of accuracy, turnaround time and client satisfaction. By combining state of the art technology with analyst oversight, every bill is subjected to a rigorous review by Definiti’s team of expert analyst averaging over twelve (12) years of bill review experience. Additionally, our program includes a quality assurance process that includes a 100% bill audit.
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National PPO Access
Definiti has established relationships with leading Preferred Provider Networks (PPOs) across the U.S. Our clients have access to a variety of PPO program networks based on geographic coverage. Not limited to a single national network, Definiti can offer the best available network, or networks, custom-designed to specifically meet the needs of your organization. In essence, a multilayered strategy that offers more than 20 broad-based and specialty networks.
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Specialty Bill Review
For services not covered by state fee schedule or PPO, Definiti’s Specialty Bill Review (SBR) program ensures our clients are only liable for the “fair and reasonable” payment of medical bills. Once a bill has been audited for accuracy (i.e. service billed is consistent with service rendered) by our team of expert analysts, the service is benchmarked against several accepted payment methodologies to establish a base allowance that is then used for negotiation or payment recommendation. Our SBR program generates savings ranging from 55% to 85% off billed charges.
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Technology Solutions
Definiti’s Medical Bill Review program is powered by a sophisticated software system, intelligent technology, advanced data management, customizable utilization flags, along with experienced professionals guarding your cost. Definiti’s technology combined with dedicated compliance expertise identifies inaccurate, inappropriate and excessive charges on medical bills. Definiti’s bill review solutions ensures adherence to each state’s regulatory requirements and recommends defensible reductions.
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