How much am I paying?
Where is my data?
What do these results say - are they good?
Isn't all bill review the same?
Who exactly am I paying?.....
Welcome to the complexities of bill review. We've seen it all, from "fluffed" savings figures to the myth that you need a network giant to get the best savings. It's time to test your savvy and see how much you really know about this critical aspect of healthcare management.
Can you explain your data?
When it comes to savings reports, not everything is as it seems. "We often hear from clients that they cannot access their data. You should have full access to your data, it belongs to you." says Tracey Williamson, our AVP of Bill Review. "Your data isn't just about numbers on a page you see on a monthly or quarterly basis—it's about understanding the methodology behind the savings and ensuring clarity with where you have been and where you should go.
Were you involved in your program customization?
Isn't all bill review the same? The answer is an emphatic "NO!". Different platforms offer different levels of customization, and this can make a huge difference in your outcomes. Mark Hostetler, our VP of Information Management, explains, "True customization is key. From bill workflow optimization to applying exception logic through custom rules, the more tailored your approach, the better the results. Whether it's designing specific workflows for certain types of bills, or crafting custom rules to accommodate unique exception processing, having the flexibility to customize your bill review process is critical." Williamson added, "It's not just about the technology; it's about how that technology is used and how nimbly it can evolve to meet your specific needs.”
Do you know you have choices?
This industry often tells you what you can't do. "You do have choices," Williamson emphasizes. "A well-structured, intentional approach can deliver exceptional results. You can leverage the right resources and have a team that understands the intricacies of the bill review process and works in tandem with you to create optimal solutions." Don't be afraid to challenge the norm. Don't be afraid to ask questions and share your struggles. If you have the right partner who has your program's best interest at heart, they will not limit you.
So, how savvy are you?
The truth of the matter is - you shouldn't have to be! Your partner should be your expert - evolving your program and bringing ideas and innovation to your future success. It's all about understanding the details, choosing the right partners, and ensuring transparency is the foundation of your partnership. At EK Health, we've been asked to demystify bill review time and time again and we're committed to helping our clients see through the smoke and mirrors with the goal of lower medical paid overall, per claim, and per bill and ensuring the optimal savings outcomes are achieved.
Discover how you can achieve optimal savings without the fluff. Let's get smart about bill review - together.
Have a claim you need asssitance with?
