I am an experienced independent Medical Auditor specializing in auditing and negotiating medical bills for Jones Act, Longshore, and Self-Insured employers.
We audit bills from providers and facilities all over
the United States and have extensive experience
adjusting medical invoices related to all commercial
illness & injury Claims:
· Jones Act
· Longshore & Harbor Workers’ Compensation
· General Liability
Instead of relying on generic computer programs to generate estimates, we work diligently using every tool available to pinpoint potential savings during the line-audit process. We review all invoices line-by-line according to the state’s “Usual and Customary” Fee Schedule, scrutinizing each entry to identify inaccurate, extraneous, or duplicate charges. Upon request, we can also conduct a “medical necessity” review to carve out any unnecessary or unauthorized charges.
For Jones Act Claims, we also perform a comparative analysis of federally-published
“Usual and Customary” charges to calculate a fair settlement. We negotiate signed Settlement Agreements where appropriate to secure more substantial discounts from medical providers such as:
· Hospitals & Ambulatory Surgery Centers
· Physicians & Home Health services
· Anesthesiologists & CRNAs
· Physical Therapy Clinics & DMEs
· MRI & Diagnostic Testing facilities
· Ambulance & Air Transport services
RAPID TURNAROUND TIME:
For medical invoices received via e-mail, we have line-audits returned to you within three
(3) business days. For settlement negotiations, we usually obtain a signature within two (2) weeks, but sometimes within a few days, depending on the medical facility’s protocol.
COMPETITIVE FEE STRUCTURE:
We provide our auditing services on a contingency basis—if we don’t save you money, there is no fee for our services. It is a win-win situation for our Clients. Our invoicing is simple and straightforward, with no hidden administrative fees.
Our invoice is calculated at a fixed percentage of the savings for each audited medical bill, for both Fee Scheduled line-audits and Settlement Agreements.
We can charge less than the industry standard of 25-35% for our audit work because we have streamlined the Medical Audit Process by conducting communications via e-mail
and electronic fax, eliminating the expenses of postage & hard copy. All audits are stored electronically for ten (10) years at no additional charge.
The bottom line is: If we don't save you money on a bill, you don’t get a bill from us.
We "know the ropes" when it comes to negotiating medical claims.
Try our zero-risk audit services today to cut your company's Cure costs in half.