Claim savings don’t have to end with the PPO network discount. With MedBen’s forensic claims review services, savings are produced after network discounts are applied, but before claims are paid.
As the case study below shows, while PPO network discounts alone will reduce a claim’s cost, forensic claims review goes beyond the discount by detecting and correcting any claim inconsistencies.
Our surveillance system flagged a claim for Acute Pulmonary Embolus. Reviewing the claim, we found the patient was treated with inappropriate medications not in keeping with the standard of care, and received five days of medically unnecessary treatment.
Through the PPO discount and forensic claims review, the client saw an overall savings of 56%.
Forensic claims review features leading-edge cost containment tools that combine talent, technology, and a physician-driven approach to ensure you pay the right claim at the right price. To learn more about these leading-edge solutions, contact your broker or call MedBen Marketing at 888-627-8683.