Delivering expert medical bill review services to the workers' compensation industry through custom programs designed to fit the unique needs of our valued clients.
Who We Serve:
Proudly serving insurance carriers, third-party administrators, self-insured employers, risk pools, consortiums, and other cost containment entities in the workers' compensation community.
WORKERS’ COMP 101 – WHAT IS MEDICAL BILL REVIEW?
Accidents happen! If the accident results in a workers' compensation injury, then the employer is liable for payment of all related medical treatment.
As medical providers have considerable latitude in regards to how they bill for services, the responsibility of determining the precise dollar amount of workers’ compensation medical provider payments falls on the payor.
Determining the exact amount due to each provider can be tedious and complex. AMCC’s medical bill review program helps you navigate and streamline the process.
Factors impacting provider reimbursement include:
State Mandated Fee Schedules
Usual, Customary & Reasonable Fees (UCR)
National Correct Coding and Global Edits
Provider Type and Complexity of Treatment
Network Participation
Supporting Documentation
Medical Bill Review is the process of analyzing each bill and determining accurate reimbursements.
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