ICC’s bill review system provides a national rules-based bill review service with the flexibility and scalability to accommodate our clients’ needs. We apply the latest fee schedules, usual and customary rules, proprietary code-specific clinical edits, and automated provider network discounts. In addition to the market leading bill review software suite, ICC offers solutions designed to help customers increase operational efficiencies and cost containment in the broader claims environment with unsurpassed turnaround time.

Key Solution Components

• Extensive coding review and repricing
• Automatic fee schedule and state law adjustments
• Contractual provider discount application
• Customizable utilization review parameters/flags
• Robust duplicate bill detection: 99.9% accuracy vs. 85% industry average
• Aggressive fraud detection
• Seamless referrals to our Negotiations unit

Claims Transmission Options

• Fax
• Email
• File Transfer Protocol (FTP)
• PDF or comparable image file format
• Batch exports in CSV format
• For other methods and file formats contact ICC

Through the use of professional negotiations, specialty audits and an extensive provider history database, ICC can determine which cost containment method to utilize on a per-bill basis.  This ensures that not only the maximum savings our achieved, but that risk is minimized in relation to provider push-back.  This is the perfect alternative for Payors that have been hammered by provider appeals and member balance billing.

The ICC Specialty Audit program uses public provider data to develop benchmarks of reimbursement that are accurate, transparent, and defensible.  This process provides a useful option for uncooperative healthcare providers that refuse to sign discount agreements pre-payment.

The cost of overpaying workers compensation claims can reach millions of dollars in revenue and lead to increased premiums for employers.  By using ICC’s Overpayment Recovery program, claims costs can be dramatically reduced.  ICC will secure refunds on your behalf with NO RISK involved.  Our fee is contingency based on a percentage of the savings.  If we do not successfully recoup a refund, you pay NOTHING!

Criteria for selecting eligible claims include:

• Paid amount over $10,000
• Hospital or Ambulatory Surgery Center (ASC) bills
• No negotiated agreement in place
• Provider has not appealed payment

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Healthcare Professionals Recovery

Using ICC’s expert knowledge with state workers compensation guidelines, our team has developed a successful program to maximize the collection and recovery of closed workers compensation files, which includes claims with zero balances.  ICC is able to assist clients in determining whether their insurance denials or reductions are valid.  We possess the state specific knowledge necessary for the collection of denied, uncollected, and disputed workers compensation claims.

We provide a comprehensive review of each closed file. By using the ICC program, maximum revenue will be recovered with timely results. We pride ourselves on offering a unique combination of experience and professionalism that is best in class in the industry.

Using ICC’s unique approach to cost containment, we have recently implemented our Second Look™ program.  This program allows payers to insert ICC as a second option to their current negotiations and bill review vendors.  We then use our patented approach to attempt negotiations on high-dollar claims that have been unsuccessfully negotiated.  We are proud to have developed relationships with providers nationwide, and with the Second Look™ program, have been able to achieve savings on many claims other negotiators were unsuccessful in adjusting.

Another area addressed with this program are claims that fall below established dollar thresholds.  Many cost containment companies today are structured in a way that they are not able to effectively handle and reduce low-dollar claims.  Rather than bypass savings on these, ICC can be utilized to expand the cost containment net for payers and maximize overall savings for an otherwise untouched category of medical claims.

Using ICC established procedures for successfully securing the highest possible savings, our experienced team of Negotiators are able to obtain discounts, while maintaining a positive and mutually beneficially relationship with the provider.

ICC’s proprietary software allows negotiators to access claim history for all providers to leverage negotiating power. Our highly qualified negotiators work with non-contracted providers to obtain the maximum discount on out-of-network claims. Negotiated settlements benefit providers by providing expedited payment and a voice in their reimbursement, while acting as a safeguard with a signed agreement versus other Usual, Customary and Reasonable cost reductions. We are able to consistently reduce Medical Claims by 30-50% across all lines of insurance with signed contracts enabling us to close settlements promptly and professionally.

ICC is also capable of initiating negotiations prior to the time of service.  Pre-negotiations include contacting a patient’s provider prior to service to establish reimbursement guidelines. By establishing a presence with the provider early in the claims process, ICC is able to lower patients’ medical bills and save clients precious healthcare dollars.

Claims Negotiation Services program offers:

• High Success Rates
• High Discounts
• Experienced Negotiators
• Written Provider Consent
• Fees based on Successful Negotiations
  

ICC Negotiators can be used to:

• Handle a sudden influx in claims volume
• Cover for a departed employee(s)
• Increase average discount rates
• Forgo the expense and time of hiring new negotiators
• Bring experience to complex or unsuccessfully negotiated claims

ICC is committed to assisting our clients in determining whether their insurance denials or reductions are valid. We insure the highest quality of recovery by employing a team of experts that are able to recover reimbursements for files that are denied, uncollected, or disputed.

There are no up-front fees for our services.

This is truly a “risk-free” service and our fees are based upon the amount collected – and there is never a charge for uncollected claims.

We are specialists in the recovery of reduced or denied charges.  We employ professionals with the experience in the workers’ compensation sector across the nation.  Our experienced staff has:

• A strong understanding with specific collection needs of healthcare providers

• A proven track record of successfully recovering lost revenue from MDs, DOs, DCs, rehabilitation facilities and hospitals

We provide an exhaustive review of each closed file. By using the ICC program, you’ll see recovered revenue and fast results. We pride ourselves on offering a unique combination of experience and professionalism that is rarely seen in the industry.

Formed in Austin,Texas we continue to build and maintain strong partnerships with industry leading Bill Review Firms, Third Party Administrators, and Payers. Through our Workers Comp Overpayment Recovery program, we are also able to offer an option for payers that have already paid workers comp claims above state mandated fee schedules.

We are able to fully integrate key financial tools, expert negotiations, and years of industry knowledge into a single knowledgeable program to deliver a powerful and poignant cost containment solution.  ICC is effectively able to reduce medical claims from hospitals, freestanding surgery centers, ambulance services, physicians, skilled nursing facilities, and rehab facilities.  When appropriate, ongoing discount arrangements can be made for end stage renal care, long term rehab and physical therapy, and long term inpatient stays.

The most effective method is utilizing a Professional Negotiator to maximize savings. This method is also Risk-Free, as fees are based on a percentage of savings only if the Negotiator is successful. This is also the only way to eliminate any future liability, as negotiations are supplemented with signed agreements from the medical provider. This will ensure that your account is settled and closed once and for all.

In today’s economy, households and businesses are paying closer and closer attention to their budgets and bottom lines.  Effective medical cost containment can have a significant impact on your, or your company’s, financial situation.