Workers' Comp

Combined Solution Maximizes Savings


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A provider billed for a complicated diagnostic-related group (DRG) on a $204,517 facility bill.


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A physician advisor reviewed the high-dollar bill as a part of the facility review, which is a component of the AuditPro product.


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The physician advisor found that the provider did not document any actual complications to validate a complicated DRG. The DRG was reassigned to a code for the same procedure without complications. This reassignment saved the client $18,364.


Cost Saving

Physician advisor saved a client $18,364 on one facility bill




Enlyte has expanded its back-end bill review process to identify additional savings categories and maximize cost containment. These reviews provided us with additional savings and reduced the overall cost of our program.

Claims Manager / State Fund


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