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Ingenix Medical Bill Review

Ingenix Medical Bill Review offers advanced bill review capabilities, backed by one of the industry’s most authoritative databases for fee schedules and relative and actual charge data (RACD) from all 50 states.

Maximize efficiency with one powerful solution that automates processes and provides detailed reporting metrics for decision support.


NEXT GENERATION SOLUTION

Ingenix Medical Bill Review (IMBR) is built on the foundation of Ingenix PowerTrak®, one of the most comprehensive, up-to-date bill review solutions in the industry for workers’ compensation and automotive injury insurance medical bills. IMBR will help you minimize claim severity, improve medical cost savings, and adhere to state fee schedules, regulation, and industry standards.

VALUE

  • Increase productivity through automation
  • Improve accuracy with detailed bill review
  • Speed response times to state regulation updates
  • Make fact-based decisions using detailed reporting metrics

THE POWER OF AUTOMATION

The Ingenix Medical Bill Review system enables the creation of customized workflow rules; flags duplicate bills, overutilization, and fraud; and speeds response to state regulation updates. In addition, it will help automate quality assurance processes by automatically flagging a defined percentage of bills for each user and provides comprehensive reporting capabilities.

MEDICAL BILL REVIEW TECHNOLOGY

IMBR utilizes a design methodology based on Service-Oriented Architecture (SOA) with Web services connections which makes it easy to adapt to changing technologies, simplifies integration with other systems, and streamlines the creation of business processes from existing services.

Additional Ingenix Offerings

Ingenix Alliances (Ingenix Property & Casualty Network and Out-of-Network Alliances)

Ingenix partners with some of the best national and regional medical provider networks as well as negotiation and repricing vendors to yield even deeper discounts. By establishing electronic bridges with our external partners, we are able to facilitate greater network penetration. We also offer a comprehensive network module that enables seamless application of proprietary and internal network contracts.

Ingenix Fee Negotiation Services

Ingenix Fee Negotiation Services includes two contingency based services: Pre-bill and Post-bill. Whether you use one service or both, our cooperative strategy yields signed agreements, no reconsiderations, and perhaps most importantly, stronger relationship with your providers. Historically, our clients save an average of 20-25 percent on approximately 60 percent of the bills pursued. Find out more.

Ingenix State Fee Schedule Plus Module

The Ingenix State Fee Schedule Plus Module is a database comprised of timely and consistent fee schedule data serving organizations that adjudicate or review workers’ compensation and auto medical bills. Ingenix created a uniform format for fee schedule data across all available states to eliminate inconsistencies and provide unmatched ease when implementing multiple state fee schedules and RACD pricing modules. This module helps payers obtain timely and consistent state fee schedule data, develop and implement state fee schedules with ease, and advance optimal bill review efficiency.

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