After a traumatic event, injured workers may want to avoid the scene of the accident. But returning to work could help them heal.
When medical bill review is managed by internal teams, performance depends on sustaining specialized expertise and the ability to scale operations in the face of turnover, volume volatility and unexpected disruptions. For many payers, as bill volumes fluctuate and labor pressures increase, sustaining consistent turnaround times and maximizing savings can place growing demands on internal teams.
Not all durable medical equipment (DME) referrals are completed at purchase. Some include warranties that need to be monitored and maintained, including items like wheelchairs, respiratory equipment, prosthetics and patient lifts.
Expanded utilization review helped a self-insured employer control rising surgical costs, reduce unnecessary procedures, and generate over $1M in savings while maintaining a two-day review turnaround.
See Michele Hibbert break down the impact of new state legislation on AI-powered claims processes in this exclusive Business Insurance "Comp Spotlight" interview.
Read how New York's strategic utilization review expansion kept medical payments stable despite rising costs nationwide.
Discover how to prevent Medicare from disrupting your settled claims. Learn when MSAs are needed, what documentation to gather upfront, and strategic approaches to identify cost drivers.