Medical Review Services
Maintain visibility throughout the bill lifecycle and realize medical cost savings
With today’s ever-rising workers’ compensation costs, it is difficult to contain costs and remain compliant without having visibility throughout the bill lifecycle. Genex’s Medical Bill Review helps companies improve bill analysis to make better claims decisions, realize deeper savings throughout the claims process, and optimize workers’compensation programs using comprehensive bill review data. This service, combined with tenured bill review expertise, integrates bill review information seamlessly across systems and services to provide much needed visibility and deliver analytics-driven program enhancements.
More than 500 self-insured customers rely on Genex’s Medical Bill Review Services to deliver cost savings. A consultative approach to developing customer-centric workflow that leverages best-in-class automated rules helps advance bill analysis so you can quickly identify and implement clinical intervention actions to improve outcomes. Customer-specific medical bill review program data is used to identify actionable ways to improve your program, including easy-to-implement services and system options.
Studies show reductions as high as 25% in workers’ comp medical costs*
Why Choose Genex’s Medical Review Services?
- Advance bill analysis for better claims decision making
- Improve outcomes with early identification and clinical intervention
- Drive consistency throughout review process
- Reduce time spent routing claims
- Achieve maximum savings on every bill
- Receive accurate payment recommendations
- Comply with state regulatory and data call requirements
- Customer-centric, automated workflows using best-in-class rules
- Dedicated compliance and clinical expertise
- Built-in intelligence, including automated NCCI edits, to flag bills with coding programs
- Seamless access to all medical review services through one entry point
- Clinical alerts integrated directly into case management system
- Professional medical support on claims
- Seamless connectivity to PPO networks in all 50 states
- Electronic data interfaces with partner systems
- Direct reporting in states where required
- Ongoing system customization based on customer specific analytics