We bill to the state fee schedule, challenge every improper reduction inside the window, and collect the award. You pay only on what we recover.
No contract change. No software to install. Your biller keeps everything else.
Workers' comp and no-fault claims don't go to a health plan. They go to a property-casualty carrier whose bill-review vendor prices every line to the state schedule, applies a network discount, and reduces whatever it can. The only way to fight it is a state process with its own forms, fees and deadlines.
One public bill-review vendor runs more than 100 million rules. Vendors are paid partly on the savings they find, so every line is a candidate.
California gives you 90 days, then 30. New York no-fault gives the carrier 30 days to pay or deny and gives you the arbitration. Miss the window and the money is gone.
The average second review recovers about $96. Nobody pays a biller to chase that. Across a year of bills it is the difference between taking comp patients and turning them away.
Send us twelve months of explanations of review. We price every line to your state's schedule and return one number: what was improperly reduced, and how much is still inside the window.
We price, attach the required reports and route each bill to the carrier's designated clearinghouse. Authorization requests go out with the guideline citation and get tracked.
Every EOR is read and every reduction classified. Second reviews go out within days, not weeks. Disputes that survive go to IBR, MFDR, HP-1, Forthright or AAA, drafted to the forum's limits and signed by licensed staff.
We bill the penalty and interest the statute allows, track the award to payment, post it, and show you the recovered dollars by carrier every month.
You send us the explanations of review. We send back a one-page report within ten business days.
Comp and auto are 8 to 35% of revenue and the slowest receivable on the books. We take it whole.
A separate queue nobody wants, outsourced by RFP at 3 to 8% with no filing guarantee. We bid lower and guarantee the window.
Millions of visits a year to carriers, where the fee schedule is the margin. We find the systematic underpayments and file in batches.
Verification requests, arbitration and billing under one roof. Your lawyer keeps the hearings and the fee.
No. We take an 837 export or work inside your system. Your health-plan billing does not move.
Licensed billing staff on second reviews and state bill disputes. In New York and New Jersey no-fault arbitration, an attorney of record from our affiliated firm, or yours if you prefer.
Then the statute does the work. A carrier that misses its deadline owes penalty and interest in most states, and in Florida waives its objections. We bill for all of it.
Keep them. We screen every bill, file the ones that belong in arbitration, and hand your lawyer the hearings and the fee. Most firms see more cases, not fewer.
A business associate agreement before any file moves, and a secure upload.
Everything inside the window is still recoverable. Every day you wait, some of it isn't.
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