Medical Bill Review

Maximizing Savings

With the combination of our experienced medical bill analysts, nurses and state of the art technology Novare is able to deliver maximum savings. Our Bill Review services can be customized to client specific business needs. Novare offers the flexibility to create specific business rules and apply those rules to assist in creating a more streamlined process. Our hands on approach ensure open communication with all clients during every phase of the Bill Review process. By offering a winning integration of multiple elements we are able to offer a powerful total savings solution.

• Medical Bill Review
• National PPO and Specialty Network Offerings
• Out of Network Negotiations
• Specility Bill Review

Medical Bill Review

Novare achieves maximum savings by applying multiple reductions elements.

* Workers Compensation State Fee Schedule and Usual and Customary discounts:
Novare applies all fee schedules reductions and billing ground rules to each medical bill, as set forth by each state to capture the greatest reductions for our customers. In states that no fee schedule exists Usual and Customary reductions are applied to combat excessive and over utilized charges.

* Detection of duplicate charges
Novare detects not only “true duplicates” but duplication of concurrent care is also detected.

* Detection improper billing
Each bill is audited for any improper billing practices such as coding, unbundling of services or any non-compensable charges during the Bill Review process.

* Customization of specific business rules
The ability to create specific business rules to streamline the bill review process guarantees the application of any client’s specific needs.

* Integration of Utilization Review Decisions
With real time integration of Novare’s UR module detection of all non -authorized treatment is seamless. This real time integration allows for a fast application of any unrelated or non- covered charges by our skilled team of bill analysts.

National PPO and Specialty Network Offerings

Novare can delivery significant reductions below worker’s compensation fee schedules and usual and customary rates through integration of state-specific networks such as a Texas HCN and our access to multiple provider networks based on each induvial client’s need. We can perform network analyses to identify any opportunities which could maximize overall network savings.

Out of Network Negotiations

Novare provides out-of- network negotiations using an experienced, professional staff. Customized solutions can be created to fit each client’s needs. We offer programs that include signed agreements from medical providers and direct negotiations with medical providers.

Specialty Bill Review

To combat excessive charges Novare provides a specialty Bill Review service that consists of in depth audits of any complex provider medical bill. Our staff reviews all coding and associated medical records for verification of correct submitted billing and to verify the submitted medical documentation does support the individual billed codes. Clients are able to customize a program that fits their needs and that will achieve the most savings. Our staff consists of experienced auditors and a nursing staff who strive to achieve maximum savings for all clients.