Risk Management Information Systems

Bill Review

"Your Way" - UCR, State/Federal Fee Schedules and support for HMO/PPO's are included.

Available on-line or installed at your site.

Various pricing options include ASP, Per Line, Percentage of Savings or Purchase rights of use.

Fair Setup Fees, Support and Training.

EOB's, UCR and CPT procedures by zip code, CPT bundling/unbundling, and NDC tables for drug re-pricing capabilities.

Duplicate checking and workflow edits for items such as follow-ups.

The program checks to see if the specified vendor has a valid HMO/PPO. If so, it will utilize the HMO/PPO's rate table. When a rate table is not specified (or found), the vendor's State table is used.

UCR percentiles are utilized by the program, based on the provider's zip code, for the line items ignoring the $ per Unit value in the fee schedule.

Override State flag can be set to instruct the program to calculate the amount of the line item using both of the above methods and display whichever amount is lower.