This is where our people really shine. The larger the bills, the more we can dig into their intricacies and extract enhanced savings for clients. Compared to traditional repricing methods, Rising produces 33% in additional savings by tapping into the talents of our most highly trained, experienced staff:
• Certified Coders
• Nurse Auditors
• Physician Panel
• Professional Negotiators
• Leadership with Claims Backgrounds
Reducing our clients’ financial exposure, Rising’s team tackles a range of complex medical billings:
• In-patient/out-patient hospital bills
• Diagnostic testing bills
• Home health bills
Surgery bills
• Excessive pharmacy/durable medical equipment (DME) bills
• Out-of-Network bills
• Implant and supply overcharges
• Bills with causal relationship/compensability issues
• Bills with reasonableness and necessity of treatment issues
• Bills exceeding $2,500 (or other amount specified by client)
Acting as a second level of audit, Rising’s Complex Bill Review solution is integrated with our Medical Bill Review program to get the best savings results. It can also be implemented as a stand-alone service for payers who want to supplement an existing bill review program with specialty repricing for their highest dollar claims.