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.
SISCO’s actions on this particular client claim resulted in a $43,000 savings by identifying an excessive charge for an extensive heart surgery. To verify the accuracy of the claim, the Bill Review unit requested and audited all physician notes and medical records. The desk audit confirmed that the amount billed exceeded reasonable billing compared to area providers.
Download this case study to see the rest of the results and how SISCO saved over $40,000 for one of our clients!
GET IN TOUCH
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.
For more information about SISCO’s strategic bill review, please contact your SISCO Representative, or click here.