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Cost Containment/Medical Bill Auditing and Review

The purpose of the Cost Containment Unit is to analyze, review and recommend payment to medical providers, hospitals, ancillary medical providers, rehabilitation services and pharmacies.

• Knowledgeable medical specialists, including registered nurses and physician advisors, along with state of the art software, help achieve maximum cost savings
• Medical bill reviewer professionals analyze, review and recommend payment to medical providers based upon statutory rules or guidelines and/or provider reimbursement contract amounts
• Medical reimbursements are reduced, on behalf of our clients, to the level appropriate in terms of:
  • Medical necessity
  • Treatment actually rendered
  • Adjuster authorizations
  • Usual or reasonable and customary charges
  • Utilization practices
  • Applicable fee schedules
  • Contracted agreements
• Timely payments to providers meet statutory regulations on the type and amount of reimbursement and significantly reduce costs to clients

USIS and SERVICE BEYOND THE CONTRACT are registered service marks of USIS, Inc.