Medical Bill Negotiations & Claims Review

Founded in 1994 Woodall & Broome has become a leader in the industry with a holistic approach to investigating claim and medical service solutions. Evidence based analysis of medical bills, records and itemized charges promotes our ability to negotiate reimbursement for many high cost medical services.

Why Woodall & Broome Negotiation Services?

Surgery and hospital admissions are by far the most costly expense in the life of a claim. These occurrences are less frequent but will significantly impact reserves if not managed, audited and investigated. Woodall & Broome negotiates services and treatment directly with the facility or medical provider to obtain signed agreements on your behalf. In contrast to most PPO network arrangements Woodall &Broome works for you with direct negotiation that produces superior results. Each agreement / is unique to a single service or admission as approved by your claims representative.

Our team is led by a highly credentialed physician negotiator who serves on the AMA advisory panel for the American Medical Association. Our ability to promote savings with respect to similar discipline and experience in the medical field produces savings results. Often, having common knowledge of clinical examples, coding detail and potential alternatives for pricing translates to savings absent of dispute or denial.

Since its inception Woodall & Broome Bill Negotiations & Claims Review Services has saved our clients millions of dollars beyond state fee schedules. You can trust our team of experts to carefully review all options including fee schedule, legislative and national comparison values.

• Let Woodall & Broome Bill Negotiations& Claims Review Services investigate if you received the best price! On average we save our clients 20-30% beyond state fee schedules. We have built relationships with the medical community and promote communication specific to the treatment provided resulting in savings for you.

• Do you know if you are maximizing your savings through medical bill review services? We have found that there are significant upcharges, billing errors and packaged services billed by hospital providers and physicians in error.

• According to the Office of the Inspector General, this is an issue that costs insurers billions of dollars per year. These dollars are going undetected due to complicated and inconsistent coding and medical billing patterns.

• Our bill negotiation process will enhance your current program and savings generated on these specialty bills.

Our Services

  Hospital Bill Negotiations

All Woodall & Broome negotiations are based on our audited findings to achieve reduced and accurate reimbursement. Our auditor re-prices all medications, supplies, operating room items, laboratory and imaging studies, special services and other tangible items including implants and verification of cost. Negotiation provides an avenue for these matters to be addressed outside of a lengthy administrative process but more importantly makes them visible in the form of savings.

Lien Negotiations

Claims administrators can resolve liens, but how much time are you spending? With laws constantly changing our clients have trusted our lien negotiators for their expertise in current case law, legislative and regulatory changes. The Woodall & Broome team has extensive experience in reviewing, negotiating and resolving liens without unnecessary litigation. The benefit of bill review and clinical coding knowledge allows our negotiators to validate legitimate disputes and produces remarkable savings in settlement.

SURGICAL BILL AUDIT              

We work in concert with your claims staff to ensure that medical procedures reported and billed are in accordance with all coding guidelines and more importantly that documentation supports their use. Over 40% of surgical bills have reported procedure codes that are inconsistent with procedures described in the operative report. We correlate procedures to the many procedural code choices available and present packaged reimbursement options for reimbursement. We achieve cooperation with providers and are able to levy savings below fee schedule thru concise examples and communication of clinical and coding details resulting in reduced payment for our clients.

 • AMBULATORY SURGERY CENTER

ASC center facility fees and coding are audited and analyzed with national usual and customary price data. Much like our surgical bill audit this data along with the operative report and code application findings are discussed with the facility to achieve fair and accurate reimbursement. In many states reimbursement is based on billed charges. We will work with the facility to determine the reasonable fee for service rendered. Verification of actual charge and services leads to tremendous savings and each Woodall & Broome negotiation is done specific to the unique patient circumstance and service rendered. All signed agreements are achieved as a direct agreement between the payer and provider.

CLAIMS REVIEW

We can assist in evaluating many of your claims decisions both prospectively and retroactively. Cost projection and treatment plan evaluation including peer review, medical necessity, medication and dispute or overpayment recovery options are also available

Woodall & Broome Claims Review Services, providing you with strength of assurance and knowledge for your claim decisions.

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