Medical Review
GENEX provides nationwide Medical Review Services for all jurisdictions and fee schedules. Through our experienced, professional staff and our efficient, streamlined paperless processing, we are able to create greater savings for our currently more than 500 self-insured customers.
Our QUESTSM automated bill review system is designed to provide significant reductions in medical costs in conjunction with timely and accurate payment recommendations. In fact, an independent GENEX survey has shown we are currently saving our customers more than 25% of their Worker’s Compensation medical costs.
QUEST automatically adjudicates medical bills against fee schedules and/or reasonable and customary data mandated for maximum reimbursement levels allowable. 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.
Our reputation as a valued business partner is in large part based on our highly trained and experienced staff that knows how to maximize results. Our skilled medical bill auditors, consulting physicians and registered nurses thoroughly understand how to evaluate the bills and reports they are processing and entering. By being proficient with and accurately applying fee schedules and reasonable and customary schedules, we are able to help our customers streamline their internal claims payment process, successfully reducing costs.
Network Coverage
In addition to professional medical claims support, a key component of a cost-effective managed care program is its PPO network selection. For this reason, GENEX has made it a priority to partner with the most comprehensive selection of provider networks—national, regional, and local—in the country. Our extensive, nationwide network selection allows clients with multiple locations to select from among networks best suited to their individual requirements. |
