Catching and correcting billing errors on commercial facility claims before they’re paid is challenging and time-consuming. Many health plans don’t have the resources needed. They pay these claims without ever seeing the detail and end up overpaying.
MultiPlan’s Itemized Bill Review Service doesn’t just see the detail, we scrutinize it to ensure it’s accurate. We use two layers of review, comparing billed charges against both payor and industry guidelines, such as network contracts, coverage policies, CMS guidelines and the National Correct Coding Initiative Policy Manual. Using our in-depth reviews and analysis, we identify potential billing errors such as duplication or improper unbundling on 90% of claims we review, and less than 1% of the claims we identify with errors are appealed.
Let us help you improve accuracy before you pay high-dollar facility claims.