To determine accurate reimbursements, we focus on appropriate charges not billed charges: first we pare down the bill to appropriate treatment items; then we negotiate to remove inappropriate charges and reduce any legitimate yet still excessive charges. We leverage our medical expertise, contractual relationships, repricing databases, veteran negotiators and expert coding review to provide the precision required to ensure you pay for only what’s right. We also make certain policy limits, legal issues and compliance guidelines are all taken into account in your workflow.
Rising’s proven track-record shows we’re meeting a systemic need: 30 - 50% of the time our negotiators deliver fairer results to clients. Here are two recent examples, always with provider agreement:
• Resolved nearly $100,000 of inappropriate medical charges
• Unraveled a complex bundling issue that saved our client $350,000
Benefits to You and Your Insureds
• Savings from 18% - 60%
• Provider sign-off/confirmation on every case alleviates dispute concerns and legal costs
• Better negotiation success rates and discounts through quick pay feature
• Flexible options: use as part of our Medical Bill Review program or as a stand-alone service
• Easily integrates into existing workflows
• No cost to you without savings from us