Maintain visibility throughout the bill lifecycle and realize medical cost savings

Gain transparency into cost, quality and utilization of care

We apply our extensive clinical expertise to every bill reviewed. Our dedicated compliance staff is tenured and specialized in bill review. You receive a true idea of what you are saving through audited savings, so you always get the savings that is reported to you.

Find savings based on your unique needs

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. More than 500 self-insured customers rely on Genex’s Medical Bill Review Services to deliver cost savings.

Continually identify additional savings opportunities

Our customizable, data-driven program gives you a transparent view into your cost, quality, and utilization of care. Our program finds savings based on your unique needs and continually identifies opportunities for additional cost control.

Seamless service integration

This service can be seamlessly integrated across systems and services to provide much needed visibility and deliver analytics-driven program enhancements.

Settlement Demand Package Reviews

When it comes time for litigation and settlement negotiations, you need a comprehensive view of the necessity of treatments and associated costs throughout the claim to give you an informed position for negotiations. You need to rely on experienced medical experts to determine causation, medical necessity, and utilization so you can responsibly negotiate from an informed position backed by a medical expert review.

Implant Cost Containment 

Implant devices are very expensive and have a complex supply chain where suppliers often apply enormous markups to the actual purchase price. Additionally, complex state-specific regulations make it challenging to understand what is being billed by the facility and what the correct implant reimbursement should be.

Genex partners with ForeSight Surgical Implant Solutions to provide a comprehensive solution that determines appropriate implant reimbursement to provide significant savings to our customers. This program delivers objective, credible and defensible claim reductions and negotiations.

Realize substantial reductions on medical billing

Genex's RightSize negotiation service provides substantial reductions on medical billing by analyzing the charges and medical stay against several costing data points, from which an appropriate and fair final bill can be negotiated.