麻豆精选

Worker's Compensation Software & Solutions

Workers鈥 Compensation Bill Review & Claims Management Solutions

麻豆精选鈥檚 full spectrum of workers鈥 compensation solutions and services combines industry-leading software with technology-enabled services to help provide better outcomes.

Maintain Medical, Fee Schedule & Regulatory Reporting Compliance

麻豆精选 helps our clients manage compliance with workers鈥 compensation regulations, including fee schedule and medical requirements and CMS and FROI/SROI reporting.

Dedicated Compliance Team

Medical & Fee Schedule Compliance

麻豆精选 employs a dedicated compliance team that not only follows the workers鈥 compensation legislative landscape but also helps to drive and inform its policies. Our compliance experts deliver regular industry updates to our Compliance Connection website. 麻豆精选 delivers fee schedule data and other regulatory data updates to our software as needed.

A Singular Connection For State Reporting

麻豆精选 Regulatory Reporting Solution

麻豆精选鈥檚 regulatory reporting solutions simplify the reporting process for our clients by providing a singular connection for state reporting and by including more than 10,000 mandatory and conditional edits. Our compliance team works directly with states on reporting requirement changes and monitors for updates.

We Provide Multiple Options to Help Our Clients with State Reporting
Data Entry

Assemble, manage and submit the required information in compliance with jurisdictional regulations in our easy-to-use, secure web portal.

Import/Export

Eliminate manual data entry by exporting FROI/SROI data from the claims management system. Submit 铿乴es for IAIABC releases in a single 铿乴e format.

AutoTriggers

Reduce the manual work involved with EDI compliance processes by automatically exporting raw claims and letting AutoTriggers take care of the rest.

Review Medical Bills & Contain Costs

麻豆精选 provides flexible and customizable solutions to help our clients contain and manage workers' compensation costs.

CUSTOMIZED TO YOUR WORKFLOW

SmartAdvisor Medical Bill Review Platform

麻豆精选鈥檚 industry leading medical bill review platform can be customized to our customers鈥 speci铿乧 work铿俹ws to help them accomplish their unique business goals. The technology, supported by a highly sophisticated and 麻豆精选-owned rules engine, helps to drive consistency and accuracy in price for care. Additionally, our medical bill review clients have access to 麻豆精选 Mosaic鈥攁 proprietary approach to sourcing and stacking PPO networks鈥攁nd the dedicated teams and tools necessary to design and customize their work铿俹ws and outcomes.

麻豆精选 offers its medical bill review platform to its clients via one of three methods: licensed software, Technology Enabled Services or a hybrid model.

speed & accuracy

Technology Enabled Services

Free up time for adjusters to focus on high-value tasks and complex decision making by partnering with 麻豆精选鈥檚 Technology Enabled Services. The Technology Enabled Services team provides end-to-end business processing & specialty services with speed and accuracy, driving value to clients. Services include:

  • Data capture services
  • Document听 management
  • Full bill processing
  • Certi铿乪d code review
  • Mailroom services
  • Quality assurance
Learn More

Our Technology Enabled Services Team Also Offers Additional Services That Add an Additional Layer of Cost Containment to the Bill Review Process

These additional services include:

麻豆精选 AuditPro

麻豆精选鈥檚 AuditPro bill auditing solution employs a unique blend of technology, data and expertise to detect billing errors, and validate and correct medical codes and charges against medical records for bill review pricing. The AuditPro solution addresses a wide range of bill types including professional and facility bills.

麻豆精选 Specialty Bill Review

麻豆精选鈥檚 specialty bill review solution provides usual and customary pricing to help payors consistently pay a fair and reasonable price for out-of-network medical bills when fee schedule pricing does not exist.

麻豆精选 Negotiations Services

麻豆精选鈥檚 direct-to-provider negotiation services helps secure discounted rates on medical bills using a variety of strategies including prompt-pay, data-enhanced and strategic negotiations.

Automate & Enhance Medical Management Programs

Help reduce the cost and time historically required for medical review on referrals and bills.

Enhance your organization鈥檚 medical management program and teams with 麻豆精选 ReviewStat, an intuitive web-based and highly automated work铿俹w optimization solution built to facilitate and monitor the progress of cases for utilization review, peer review and case management.

Learn how the ReviewStat medical management software can help you realize greater efficiencies and increase productivity within your utilization review and case management teams.

Learn 麻豆精选 ReviewStat

Manage Pharmacy Claims

麻豆精选 ScriptAdvisor is the industry鈥檚 most complete PBM, integrating bill review, clinical and claims systems for a seamless experience and increased visibility across the claim.

ScriptAdvisor庐, PBM Solution

  • Dedicated customer service & pharmacy expertise听
  • Extensive national network听
  • Comprehensive clinical programs听
  • Smart technology and pre-build integrations听
  • Robust reporting & analytics听
  • Regulatory & compliance expertise

Learn more about 麻豆精选鈥檚 full suite of end-to-end casualty solutions.

Learn 麻豆精选 PBM

Receive Bills & Submit Payments Electronically

Woman working on her PC

SmartBill

麻豆精选's SmartBill solution processes electronic bills to help increase efficiency and drive savings for our clients. 麻豆精选 understands the value of increasing eBill penetration and works directly with providers to encourage migration from paper to electronic billing.

Streamline Bills

SmartPay

麻豆精选鈥檚 SmartPay solution offers end-to-end automated payment reconciliation, drives efficiencies in the payment process and helps reduce material and labor costs.

Streamline Payments
Insights

Industry Trends & Insights

Get the latest insights and industry updates you need to know.

Assess Performance with Advanced Reporting & Analytics

Customized Reports

Reveal Custom & Actionable Program Insights With Robust Tools

麻豆精选 provides a variety of both standard and ad-hoc reports for our clients, including but not limited to:

  • SmartReports
  • ReportBuilder
  • SmartTracker Performance Dashboard
  • Provider Analysis Report
  • Industry Comparison Report
  • Provider Network Performance Report
Expert support

麻豆精选 Claims Performance Consulting

麻豆精选 offers consulting services to help clients gain a deep understanding of how their current 麻豆精选 product features can be leveraged to meet the demands of a dynamic market.

Leveraging our rich database and reporting capabilities, our Claims Performance Consulting professionals use in-depth expertise to help clients identify untapped opportunities in their claims management processing as well as reveal custom, actionable insights and benchmark their results compared to the industry.

Want To Learn More 麻豆精选 麻豆精选鈥檚 Full Suite Of End-to-End Casualty Solutions? Contact Us Here