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Network Solutions

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RISING considers strategic network development a dynamic component of medical cost management and assembles for each client a Network Solution comprised of the maximum number of providers serving their respective state(s). RISING's Preferred Provider Organizations seek to provide quality medical care to injured employees while also providing a quantifiable form of reduced costs.

>> PPO Solutions

RISING delivers comprehensive coverage with its first-rate network of over a half million preferred provider locations. Such an extensive network enables RISING to meet our clients' broad-based coverage needs, and our custom network development and direct contracting services provide modified solutions to meet more specific client objectives.

Our network development professionals ensure that RISING's quality and service standards are met by meticulously evaluating provider partners. This due diligence process is essential to assess the provider's accreditation, scope of services, quality of patient care, and savings opportunities.

Our network solutions include:

  • National, regional and specialty coverage
  • Ancillary coverage - pharmacy, diagnostic, medical supplies, dental
  • Client specific "micro" network and panel development
  • Targeted network development
  • Continuous credentialing of providers' operations
  • Significant provider discounts
  • Enhanced cost savings when integrated with bill review services
  • Online PPO access
  • Channeling - card, letter, online and poster options

>> Pharmacy Solutions

RISING's Pharmacy solutions include a network of nearly 50,000 pharmacies nationwide and industry-leading technologies: the first, fully integrated technology solution that combines bill review with a pharmacy management program. Our Pharmacy services include:

  • Complete pharmacy benefit management
  • Online reporting and management tools
  • Competitive pricing
  • Email notifications of critical claim updates
  • Potential retroactive discounts
  • Card and cardless programs
  • Retail and mail order options
  • No out-of-pocket expense for claimant
  • Automated billing and payment under a single provider

>> Durable Medical Equipment (DME) Solutions

A solid part of any cost containment and quality assurance program, our DME solutions include:

  • Competitive pricing
  • Network of local, fully-bonded equipment distributors
  • Significant cost and times savings
  • Medical professionals coordinate orders to ensure patient compatibility

>> Diagnostic Solutions

RISING's full range of Diagnostic solutions provide significant savings and quality care, while simultaneously evaluating medical necessity and appropriateness. Our services include:

  • Medical Imaging
  • Scheduling
  • Pre-Certification
  • Reporting

>> Dental Solutions

RISING's Dental solutions include a network of expert professionals, from Cosmetic Dentists to TMJ Specialists. Our dental claims management process limits excessive treatments. Our services include:

  • Adjuster and claimant management
  • Screen oral evaluations to determine what is compensable to injury
  • Dental IME and Peer Review
  • Provide plan of treatment prior to rendering of dental services