What is a Medical Bill Review Service?

Computer assisted audit service which save payers time and money by:

• Providing claims administrators with quick and reliable methods of verifying the accuracy of provider charges,
• Ensuring conformity to state mandated fee schedules,
• Verifying customary charges for a given geographic area, and
• Proactively working with the provider community to ensure fair reimbursement of fees.

Through InterMed’s extensive physician and hospital PPO networks, substantial savings beyond fee schedules can be achieved.

InterMed’s Goal

• Accuracy. Our bill analysts perform a line-by-line review on each bill to ensure an accurate assessment. This "hands on" attention to detail provides:
  • Minimal reconsiderations,
  • Elimination of payment penalties,
  • Increased bill flow efficiencies,
  • Better provider relations, and
  • Increased Savings!

InterMed Provides

• A comprehensive training program during system implementation to facilitate smooth transmittal of bills.
• Periodic reviews to ensure program efficiency and objectives are being met.
• Precision application software that eliminates duplicate billing, and consistently identifies over-billing/miscoding and treatment/charges unrelated to injury.
• 5-10 day turnaround of bills.

InterMed Provides

• An Explanation of Review (EOR) attached to each bill to identify any reductions or re-coding.
• Parameters for specific number of treatment units.
• Electronic interface with major PPO’s & vendors.
• Internal quality assurance program.
• Verified accuracy of CPT codes and level of service.
• Management reporting -- provided on monthly or quarterly basis.
• Medical director backup and appeals process.

InterMed Advantages

• PPO Networks used by InterMed include the largest and most extensive contracts in the Nation.
  • Blue Cross, First Health, Focus, InterPlan, Rockport, Tennessee Health, PPOM, National Choice Care, InterMed Direct, and Beach Street, to name a few.
• Automatically cycle through multiple PPO networks, searching for membership in any of our on-line PPO networks, which are stacked in order of deepest discounts.

Results of InterMed

• InterMed saves an average of 45.5% (national average) on medical bills.
• Number of medical bills received from In-Network providers are 55% greater than Industry average.
  • InterMed -- 54% vs. 35% Industry average
• Use of the HCO/MCO/MPN increases in-network utilization to:
  • 85% of the time (on the 1st visit), and
  • 100% on subsequent treatments (due to the mandatory re-direction authorized by law).

Technical Innovation

• Electronic billing direct from providers.
• A "true paperless" bill approval process for examiners.
• Electronic access to all data elements via the Internet.