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Medical Review Services

Our bill review service offers advanced technology combined with dedicated compliance expertise to identify inaccurate, inappropriate, and excessive charges on medical bills, as well as accurate payment recommendations. Greater savings are realized as a result of a streamlined paperless process, coupled with experienced medical bill auditors and professional nursing staff.

The GENEX bill review system automatically adjudicates medical bills against fee schedules and/or UCR data mandated for maximum reimbursement levels allowable, and routes complex bills for manual intervention when appropriate. Client-specific processing rules are also incorporated into the bill review system. This unique combination allows clients to achieve maximum savings on every bill.

In addition, automated integration with PPO networks in all 50 states allows us to apply additional discounts to physician and hospital bills to further enhance cost savings.