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Bill Review Module

Our Bill Review module is an innovative solution for delivering a paperless electronic bill review environment for the workers' compensation industry, including insurance companies, employers. third-party administrators and bill review companies.

Our Bill Review module is fully integrated with Claims Advantage™ can receive electronic data files via the Internet and automatically processes bills through its repricing engine, generating an EOR and payment EDI back to the Client's Claim System. Bills can be processed directly through the repricing engine or diverted for special handling via a client configurable decision tree.

The software also allows for viewing stored images, such as surgery reports and other supporting documents when the bill review process requires it. The Bill Review module can receive bills via a paper conversion model or from clearinghouses processing electronic bills direct from providers.

System Features