Through our aggressive bill review services, our clients consistently save in excess of 50% on medical bills. Forté ensures maximum savings through measures including the application of fee schedules and billing ground rules; negotiation of fees whenever network discounts, state fee schedule reductions, or other appropriate review rationale are not available; and detection of improper billing practices (i.e. upcoding and unbundling) and duplicate billings.
Clients value our team’s knowledge and attention to detail. Bills warranting a higher level of review are identified in the system, and reviewed by experienced auditors and checked for coding errors, such as unbundling and up-coding. The following flags can be customized for each client:
- Bill Type
- Line of Business (workers’ compensation, auto, liability, longshore, etc.)
- State.
- Claim, Claimant and Client
- Provider (Individual or Group)
- Diagnosis code and service code
- Per bill and per claim maximum
- Dates of service
On hospital bills, we complete quantitative and qualitative bill analyses, and review supporting documentation to ensure the charges are appropriate and accurate. Forté applies proprietary re-pricing methodology to bills where applicable. Our audit services can also include the negotiation of high dollar bills to ensure costly charges are paid at the most reasonable rate possible.
Online Adjuster Bill Approval
Once reviewed, adjusters have online access to view and release audited medical bills prior to finalization. They can submit comments to Forté for needed changes to the bill, release it for finalization, or pend the bill for later action.
eBill
Forté offers a national eBill solution to comply with growing state mandates for providers. By utilizing our automated, cost-effective process, clients avoid costly system enhancements and set-up fees. All eBills are verified to ensure they meet minimum bill requirements; and clients have has the option to receive their eBills by fax, email, or hard copy.
PPO Network Re-pricing
Forté brings additional savings to our clients by applying PPO contract discounts from national PPO network providers. We work with our clients to identify the best PPO network partners for their claims and work with them to optimize savings. All network discounts are applied after the bill is audited to the proper amount to ensure accurate savings. Read more about our national PPO network.