Medical Bill Review
Paladin's Medical Bill Review services save every possible dollar without compromising patient care. We cover all types of medical bills through two services, Standard Bill Review and Clinical Bill Review.
Standard Bill Review
Paladin's senior-level bill analysts review bills for routine medical procedures and services, including coding, bundling, unbundling, duplicate bill logic, and pharmacy bill review. The review process combines their health care expertise with Paladin's efficient, technology-driven processes that automatically flag conflicts with state fee schedules and the discounts from preferred provider organizations (PPOs). For the most comprehensive review possible, analysts also compare billing codes against multiple databases of codes for providers, medical facilities, and out-of-scope fees.
Clinical Bill Review
As with all our managed care services, we bring in physicians at the level that returns the most value to clients. Paladin physicians review bills for which their medical knowledge can make a measurable difference, such as those involving surgery, hospital stays, multiple procedures, and/or multiple providers. As trained clinicians, physicians can pinpoint problems quickly, negotiate with treating physicians, and arrive at a fair decision that everyone can agree on.
For clients who subscribe to both the Standard and Clinical Bill Review services, the review processes are integrated electronically to prevent duplicate efforts and double-billing. The services are also available separately for clients who prefer to review certain types of bills on their own.