Medical Bill Review

Ahead of the Curve.

An experienced Medical Bill Review (MBR) team translates into maximum cost savings. Our MBR Department consists of review analysts, quality assurance specialists, jurisdictional experts and licensed nurses.

Through customized programs, the IMO MBR process captures results through: 1) Application of state fee schedules and mandated rules 2) Identification of improper billing practices 3) Integration of utilization review decisions 4) Detection of duplicate provider billing 5) Pharmacy bill review and management 6) Capability to manage network relationships 7) Electronic medical interface with pre-screen nurse review.

Additional Benefits Provided to Ensure Best Return

Paperless / Web-based Application and Numerous Quality Assurance Measures and Controls
Automated Provider Payment File and Customized Management Reports
Online Access to Bill Review Information and Automated Rules Engine
Enhanced EDI Interfaces with all Appropriate Parties
Scanning Workflows to Incorporate Bill Images, Medical Reports and EOBs
Compliance with State EDI Reporting, EOB Approval Process and ADL for TWCC