Medical Bill Review-Time for a Change? It’s Easier Than You Think

Spring is just around the corner. For most of us, it is a time for cleaning house, for new beginnings, and for routine check-ups with trusted financial advisors, with doctors, and even for our vehicles. One check-up that is not so routine is a medical bill review (MBR) check-up. accūrō Solutions has been doing our part, meeting with prospective clients to ask how long it has been since they checked up on their MBR programs. Their answers, however, have been a resounding “Too Long”.

According to data from NCCI

35% (minimum) of all medical bills contain errors. Medical expenses account for 60% of the average claims’ costs. 2-3% of your bill count represents 54% of total spend. In addition, according to research by WCRI, Vertical Integration of medical providers is continuing to increase, resulting in more medical care, higher claims costs, and longer treatment durations for injured workers. In turn, medical billing becomes much more complicated, as it requires an additional layer of analyst expertise.

Considering the average work comp medical bill is already $1,200 – just one additional point of savings is $12. Multiplied by 1,000 bills/month = $12,000/month. 10,000 bills/month = $120,000/month, etc. So, is there really a “cost” to switch to a better MBR partner like accūrō when such a significant amount of dollars is at stake?

Unacknowledged Costs

And what is the cumulative cost of not changing? When meeting with payors, it is clear that many of them have not been provided with solid benchmarks from which to draw accurate conclusions. They often don’t realize how much they are truly spending, saving, or wasting on their workers’ compensation medical bill review program. Without being provided solid benchmarks such as Net Savings (total savings after all fees and discounts have been applied), most payors are basing their MBR partner choice simply on bill charges and the usual, common billing errors.

Hence, payors are only netting average savings results, which has unfortunately become the industry standard. Having the best MBR program partner is critical to controlling costs. It requires a partner that leverages an expert team in all areas of the MBR process — advanced technology, regulatory and compliance, data analytics, experienced MBR auditing, operations, account management, and proven leadership.

These expert teams come together to always put the client first. Forward-thinking, savings-conscious payors are seeing the Net Savings performance improvements available through fresh partners like accūrō Solutions, and their companies are reaping the benefits. In a time where businesses value such enhancements and are looking to cut costs, too much is at stake to not get an MBR check-up.

Our Medical Bill Review

Check-Up helps the payor identify their current true Net Savings, so they have a real benchmark from which to begin analyzing performance. It is a very simple process to get started. When provided historic specific performance reports, we can flush out the numbers that determine how much the payor is saving or wasting. Our analysis provides the clarity needed to make an informed decision to make a change. Transparency is a key component of every client relationship we maintain. We want a client partner for life. So, is it time to schedule your MBR Check-up with our team?

About the Author

Lisa began her career in workers’ compensation 26 years ago at CorVel. She went on to become a co-owner at CompLogic and Health Solutions. In 2011, Lisa founded Splashlight Solutions, followed by Splashlight Rx in 2017. Over the years, Lisa has consulted with clients to develop effective solutions in various areas, including bill review, PBM, PPO, wellbeing, and data analytics.

Contact

(877) 222-8616