What are the Benefits of Medical Claims Review Support Services?

Physicians and attorneys representing insurance companies conduct claims review to ensure that medical reimbursement is justified and appropriate. As this is a time-consuming process that needs great attention to detail, medico-legal professionals approach outsourcing companies for assistance. Many benefits are ensured with the competent medical claims review support services that established companies offer.

Efficient Medical Claim Review – Cost Savings for Insurance Companies

Determining the accuracy and validity of medical claims is very important both from the point of view of the insurance company and the claimant. While the claimant is ensured of justifiable reimbursement, insurance companies are ensured of substantial cost savings by the preventing of payment for erroneous claims.

Claims have to be reviewed for patient eligibility. The reviewers have to determine if the claim is within the limits allowed by the health plan. Errors can occur on a claim due to wrongful entries or if incorrect medical codes are used to describe a procedure. Similarly, claimants may attempt to obtain reimbursement that is much higher than what is appropriate and justifiable.

Outsourcing companies offer medico-legal professionals dealing with such cases comprehensive medical review services to evaluate medical records and review them against the claim records. Many benefits are ensured by outsourcing medical claims review to these companies:

• Efficient medical record organization and transcription of physician notes and claimant interviews
• Medical case chronology which involves review, analysis and date-wise listing of all pertinent medical records
• Medical case summaries for a quick review of the case
• Support to interpret and transcribe all records, including handwritten notes

The efficient organization of medical records and comparison with claim records can help detect billing errors and questionable practices. These support services go a long way in helping insurance companies determine whether claims submitted for reimbursement are accurate and proper for the medical services provided.

Accurate and Timely Medical Claims Processing with the Right Service Provider

The medical claims review support services of a competent service provider ensures maximum benefit for insurers and rightful claimants. Specialist outsourcing companies have the background and resources to offer efficient claims review. Their medical record review teams are experts in the claim review support process and offer professional support to compare itemized bills with the complete medical record. They also help in pre-trial processes, including gathering of evidence. With the right service provider, busy attorneys and physicians can ensure proper presentation of evidence to support their case and ensure unbiased and error-free claim processing.