Provider Bill Repricing

United Review Services provides a timely and cost effective service to meet the needs of the auto and worker's compensation insurance carrier by adjusting the providers' billed charges to appropriate usual, customary and reasonable, contractual or medical fee schedule levels.

This service assures a seventy-two hour turn around time on bills in New Jersey, New York, Pennsylvania and other states regulated by mandated rates, or where usual, reasonable & customary norms prevail.

Experienced Registered Nurses review each bill both clinically and in accordance with state regulations.
All bills are reviewed for:

• Medical Fee Schedule or Reasonable and Customary Fees
• Appropriateness of the CPT Codes and ADA codes
• Service or billing duplication
• Unbundling and up-coding of charges/codes
• Discrepancies between codes and service descriptions
• Causal relationship issues

A simple, one page report (EOB) includes savings, payment recommendation and invoice amount. Each audit is backed not only by updated, published R&C, contractual or fee schedule data, but also by the review by an Auditing R.N. Specialist. In some cases, referral for a more detailed audit is warranted based on the initial review findings. These cases are referred for a comprehensive review of the bill and supporting documentation, with the client's approval.