Solutions Medical bill review

A proven approach
to maximize savings

We maximize savings through our robust technology, coding and clinical expertise, access to a national network of medical providers, and our negotiation services. We analyze all bills to ensure any charges are related to the injury, and we identify and re-price inflated medical charges to appropriate levels.

Careworks’ comprehensive end-to-end solutions include:

  • A service bureau to simplify your in-house workflow
  • A virtual mailroom for bill intake/scanning
  • KFI/data entry
  • Fee schedule or usual and customary and rate application
  • A robust rules engine
  • Multiple levels of auditing
  • RN complex bill code review
  • PPO network optimization
  • Electronic payment issuance
  • Bill negotiations
  • Communication with providers to minimize questions or disputes
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CareWorks provides a national network of utilization review experts which assures state-specified jurisdictional expertise. Our utilization review processes and decisions comply with all state or local regulations, and all of our services and providers comply with stringent URAC standards.