MEDICAL BILL REVIEW
Bill Review, Optimized for You
Enlyte's cutting-edge bill review platform uses advanced technology to optimize medical bill processing for claims organizations. Employing the latest fee schedules and benchmarks, our platform ensures precise claims management. Seamlessly integrated with Enlyte's pharmacy and clinical software, our system enhances accuracy and provides a comprehensive view, enabling efficient and transparent claims management.
“Enlyte’s tools automated several bill review related processes allowing our adjusters to focus their attention on end results and the judgement that needs to be applied, rather than spend too much time doing administrative work.”
—Casualty VP, National Insurance Carrier
WHAT MAKES US DIFFERENTIndustry-Leading Bill Review Software & Services
From intelligent workflows expertly customized to your business, to integrated solutions; our bill review platform can help you accurately adjudicate claims, increase operational efficiency and contain costs.
Best-In-Class Technology & Expertise
Contain costs and spend more focused time on high-value tasks
Deep Systems Integration
Accelerate medical bill ingestion and processing
Timely Fee Schedule Releases
Maintain regulatory compliance
Highly Configurable Workflow Rules Engine
Increase claim processing efficiency and improve bill review accuracy
Automation and Straight-Through Processing
Increase automation through powerful, intelligent business rules and machine learning
SmartAdvisor
SmartAdvisor is a leading medical bill review software designed for efficient cost containment. This automated, customizable platform uses advanced technology to ensure accurate, timely fee schedule information, integrating seamlessly with claims management systems, PPOs, specialty networks, and e-billing solutions. SmartAdvisor helps organizations accurately evaluate medical charges, stay compliant with regulations, and achieve significant savings. Most importantly, it optimizes the claims adjudication process to ensure the best outcomes for injured employees. SmartAdvisor is essential for enhancing operational efficiency and maximizing cost savings.
NEW UPDATED INTERFACE
DecisionPoint Redesign
The DecisionPoint software suite is expertly crafted for auto casualty insurance carriers and third-party administrators, offering a flexible solution for bill review requirements. Our comprehensive suite of integrated solutions enhances DecisionPoint's capability to streamline the claims management workflow, ensuring medical bills are repriced accurately and fairly. This leads to cost containment, improved consistency and boosted operational efficiency. Ideal for optimizing claims processing, DecisionPoint ensures a smoother, more efficient management of auto insurance claims, enhancing accuracy and fairness in medical billing.
Cost Containment Solutions
AuditPro
Our AuditPro bill auditing solution employs a unique blend of technology, data and expertise to detect billing errors, and validate and correct medical codes and charges against medical records for bill review pricing. The AuditPro solution addresses a wide range of bill types including professional and facility bills.
Specialty Bill Review
Enlyte’s specialty bill review solution provides proven and substantiated usual and customary pricing to help our customers consistently pay out-of-network medical bills when fee schedule pricing is exempt. Our specialty bill review solution is supported by a team of experienced bill reviewers, nurses, legal and compliance experts.
Negotiations Services
Enlyte's direct-to-provider negotiation services helps secure discounted rates on medical bills using a variety of strategies including prompt-pay, data-enhanced and strategic negotiations. Our negotiation services can be utilized across workers' compensation and auto claims.
ePay
When it comes to reducing claims expenses and becoming more efficient, implementing an electronic payment process is a proven way to reduce payment costs to your claims organization immediately.
- Replaces inefficient paper-based payments
- Integrated in the bill review workflow
- Helps expedite payment cycle times
- Allows providers to choose preferred payment method
eBill
Our eBill program offers cutting-edge electronic medical billing services tailored for the insurance industry, leveraging advanced technology to significantly reduce operating costs for both payers and payees. Designed to streamline electronic billing between health care providers and claims processors, eBill efficiently handles first and third-party claims, as well as workers' compensation claims. This program not only simplifies the billing process but also ensures compliance with state reporting requirements. Integrated with a comprehensive suite of casualty solutions, eBill accelerates the turnaround time, enhancing the overall efficiency of claims processing and billing.
DELIVERY MODELA Delivery Model Tailored to Your Needs
Enlyte offers its medical bill review platform to its clients via one of three methods:
Enlyte Licensed Software
Business Process Outsourcing
Hybrid Model
Need More Help? Outsource with the Experts
Our Technology Enabled Services handles your necessary, but often expensive internal operational tasks so you can shift focus to your business’ core competencies. When you outsource with Enlyte, we’ll serve your medical claims with our premier services and bill review expertise, giving you the confidence, satisfaction and trust you need when selecting a bill review services provider. You can be confident your medical claims are being served by the industry’s premier service provider with decades of bill review expertise.
Our team provides comprehensive bill review services, including:
- Medical bill processing
- Mailroom operations
- Document management
- Data capture
- Provider contact center
- Specialized third party liability demand services
Industry Trends & Insights
Get the latest insights and industry updates you need to know.
Find Out More
Combine industry-leading technology with deep market expertise to achieve exceptional claim outcomes. Schedule a consultation to learn more about our comprehensive suite of integrated casualty services and solutions.