Medical Bill Review: Uncovering the savings, item by item

At ICS, we scrutinize all your provider bills, first with powerful algorithms, then with our expert Nurse Review team. The savings we uncover are noted separately on your Explanation of Review (EOR), and any bill reductions are applied before we apply PPO discounts, which can reduce your overall PPO expenses.

Software review: bill repricing and bill audit

Our bill review tools allow us to rigorously track adherence to:

  • Fee Schedule — monitoring and applying Usual and Customary rates
  • Contractual PPO discounts
  • Nurse Code Review — including unbundling, upcoding, etc.

Nurse Review team

Each bill is matched, service by service, with its treatment plan, and with pre-certification information. Our RNs meticulously review bills for necessity, appropriateness, reasonableness, and a dozen other criteria designed to uncover savings in the billing process.

“Best of Breed” provider networks

At ICS, we provide access to a wide range of national, regional, and local PPO networks, and we’re able to offer each of our clients “best of breed” networks that are both client- and state-specific.

We perform a detailed data analysis for each client, right from the beginning, and use that information to combine the best PPO penetration in each state with the best available savings at every step in the treatment process.

Specialty networks

Our PPO networks are not limited to physician coverage. We also offer access to specialty networks of all kinds, which generates even more savings.

These specialty networks include providers of:

  • Hospital and rehabilitation services
  • Radiology
  • Physical Therapy
  • Electrodiagnostics
  • Durable medical equipment
  • Transportation services