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 Medical Bill Review 

 
 
Rising’s flagship, Medical Bill Review solution is a policy preservation tool that ensures accurate reimbursement and an extension of policyholder benefits. Utilizing a three-tiered process, Rising allows clients to make well-informed, equitable payment decisions regarding their medical expenses.

First Up - Data Integrity
At the foundation of Rising’s process is the raw, medical bill data. This is where our ultimate results orginate – so it better be good and it better be accurate. Our precision in this area encompasses all aspects of data integrity, including redundancy, automated scrubbing, dynamic logic and manual intervention.

Second Up - Technology
Rising combines millions of lines of code, advanced software architecture, multiple data sources, sophisticated information management techniques, artificial intelligence tools and complex automated processes into a powerful system that helps maximize results.

Up Third - People
Rising’s technologies and automation of standard rules are a great start: providing operational efficiencies and speed. However, it takes people with training and experience to ensure you are paying no more than necessary. Rising’s bill review auditors look at the nuances of each bill and medical records, to bring our clients enhanced outcomes. Capitalizing on the expertise of our people allows Rising to produce true quality, not just quantity.

Key Program Components

     Policy review and application

     Co-payment / deductible tracking

     Extensive coding review and repricing

     Automatic fee schedule and state law adjustments

     Usual, customary and reasonable review

     Contractual provider discount application

     Customizable utilization review parameters/flags

     Robust duplicate bill detection: 99.9% accuracy vs. 85% industry average

     Aggressive fraud detection

     Seamless referrals to our Specialty Bill Review unit

     Client web portal for bill approval and reports access

     Submission of state reporting

     Provider payment solutions

     Seamless program implementation that we like to call Simplementation™

 

Your Return on Investment (ROI):

     $8 to $78 return per $1 in fees

     Additional return of $3 to $4 per $1 in fees when enhanced with our Specialty Bill Review

 

 
 

Sales Inquires

 Email:

info@risingms.com 

 Call:

877.747.4644

Customer Service

 Call:

866.274.7464

 Write:
 

325 N LaSalle St, Ste 600
Chicago, Illinois 60654
 

 
 
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