Out-of-network claims can be a significant cost driver for clients. SISCO is here to examine claims to ensure they are medically necessary and billed appropriately to the client. Read More

SISCO identifies errors and excessive charges by auditing 100% of bills over $15,000 for medical necessity, billing accuracy, and reasonableness. Check out this blog to see how SISCO identified an exc[...] Read More

Medical bill review is at the heart of reducing the cost of claims. SISCO offers a strategic bill review process that focuses on the amount you are asked to pay, not the discount. Check out this case [...] Read More

Reducing costs for self-funded groups is a complex process that relies on several moving pieces. One of the tactics that many carriers and TPAs don't get right is strategic bill review. Read More

Effective July 1, 2022, SISCO will be posting Machine-Readable Files (MRF) in compliance with the Transparency in Coverage rule.  Read More

The Transparency in Coverage Final Rules (TiC Final Rules) require group health plans and health insurance issuers to disclose on a public website detailed pricing information in three separate machin[...] Read More

Most of us can agree that network discounts sound great. And many times they are. But while network discounts may appear to promote cost-savings upfront, your company could end up paying more money in[...] Read More

On January 10, 2022, the U.S. Department of Health & Human Services (HHS), Department of Labor, and the Treasury issued guidance regarding the requirements for group health plans and health insura[...] Read More