Three males and female at conference table

Case Study: Extending the Power of Bill Review

The Challenge

Property and Casualty – Payment Integrity

MultiPlan analysis showed a property and casualty servicer how it could strengthen its bill review and network services by:

  • Using analytics tuned to find wasteful or abusive medical billing practices not identifiable by more automated bill review programs
  • Implementing resolution strategies appropriate for the severity of issues and nature of the provider relationships

The Solution

MultiPlan is enabling a comprehensive payment integrity program to complement existing bill review:

  • In place: Clinical Negotiation – clinically-driven negotiation of non-contracted bills scoring high for potential waste or abuse
  • In process: Bill Correction – identification and denial of charges in error, for both contracted and non-contracted bills with evidence of issues missed by the primary editing process

The Results

From the program’s start, MultiPlan Clinical Negotiation has generated significant additional medical cost reduction:

  • Identifying issues on 14% of charges billed
  • Achieving provider buy-in on 47% of charges negotiated
  • Passing the $1 million mark for reduction below bill review allowed, within the first five months

Our website uses cookies. By continuing to browse, you are agreeing to our use of cookies. Read our Privacy Policy to learn more.