Bill Review
Our Bill Review Solution includes a line-by-line review of a medical bill. Items that are reviewed include, but are not limited to: medical necessity, appropriateness, coordination of benefits, integrity, validity, and pre-existing conditions. Expert reviewers directly communicate with providers to remove charges identified in a review. Bill Review services are completed on out-of-network provider bills as well as in-network provider bills.
Bill Negotiation
Our Bill Negotiation Solution is strategically designed for group health clients to discount bills above and beyond contracted PPO discounts. If a bill falls outside of a PPO arrangement, bills are discounted through expert negotiators and direct provider communication. We receive signed agreements for all negotiations.
Bill Audit
Our Bill Audit Solution is an expanded version of the Bill Review Solution. Auditing is a highly specialized bill examination and audit of medical records and supporting documentation for medical services. Health Systems International audit staff includes experienced nurses and certified coders to maximize the savings for health insurance carrier clients. If you would like to try our Bill Negotiation, Bill Review, or Bill Audit Solutions, please click here to submit a bill. (have “click here” link to the current submit a bill place)
PPO Access/Repricing
Our PPO Access/Repricing Solution provides single-source access to the largest selection of PPO networks available in the group health market. Our networks include primary, secondary, carve out, national, regional, and specialty networks. For our group health clients, we focus our efforts on providing ease of access to multiple PPOs through several interface options including XML, EDI and web-based applications.
Business Intelligence Portal
The Health Systems International Business Intelligence Portal is an easy-to-use, browser-based application that enables our workers’ compensation clients to access key performance data on demand. Clients can quickly see where their company stands on indicators that are most important to their business.
Through the Business Intelligence Portal, clients can access information from databases anywhere in the company so that data can be analyzed and shared in real time. The portal makes it simple to establish goals, assess performance, and share data with clients, members, or employees instantly. Clients are then able to make decisions faster and minimize resources for reporting—all while lowering costs.