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Claim System - Medical Bill Re-Pricing
(CSBR)
An unrealized potential for greater
savings is the re-pricing of complex Provider billings. To efficiently
review and re-price lengthy bills can be time consuming. BCM Solutions,
Inc. can assume these tasks from a carrier, thus allowing them the freedom
to aggressively pursue additional business without the burden of maintaining
a costly claims operation. You can help minimize your operations costs
while being assured our Professional and Experienced Staff will obtain
the maximum allowable savings from each bill. Our Claim System Medical
Bill Re-pricing (CSBR) is an automated user friendly health claim processing
system. It allows for the most comprehensive adjudication of claims
available.
BCM Solutions, Inc. Levels of
Medical Bill Re-Pricing- ALL of our services are available either thru
a per service line charge or per bill charge up to a set maximum.
Basic Package: Standard Re-Pricing consist of :
- Claim Billing Entry
- Diagnostic Codes
- CPT procedures
- Entry of multiple line items
- Fee Schedule re-pricing
- Generate Explanation of Benefits (EOB)
- Timely bill turnaround
- Data quality and reliability
- Service Analysis reports
- HCRA Reports
Package B: Flagship Examiner includes the "Basic
Package" Standard Re-Pricing; PLUS BCM Solutions, Inc. will provide
the following services:
- Verification of Provider licensing
- Identify and modify questionable Diagnostic codes
and CPT procedures
- Recommends Peer Review of Bill- determining price
cost necessity for procedure rendered
- Bill Notification of 180 days rule
Package C: Examiners Filtering
This level of Medical Bill Re-Pricing comprise of our "Standard
Level of Re-Pricing", "Flagship Examiner level", and
IN ADDITION, professional service custom tailored to meet your needs;
BCM Solutions' professionally trained Examiners will provide their expertise
and concurrently work with our Clients to ensure maximum savings; and
include, but not limited to:
- Multiple code adjustments per line items
- Determine By Report (BR) codes price- nonstandard
codes compared to relative value
- Recalculation of Fee schedule
- Detection of Concurrent Care
- Communicate directly with Clients to explain further
allowance may or may not be recommended
- Any additional customized Medical Bill Re-Pricing
features to suit individual Clients requests
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