Smarter Bill Review
for Maximum Savings
We combine expertise with the latest technology to reduce costs
Comprehensive
Bill Review
At First MCO, the bill review process means carefully checking every line of every invoice for accuracy and fairness. We apply pricing rules, spot costly mistakes, and negotiate better rates when needed.
- Re-pricing based on PPO contracts, UCR data, or direct negotiation
- Surgical and documentation audits to validate services
- Detection and correction of unauthorized, duplicate, and upcoded charges
- Savings on out-of-network bills through negotiation
Better Results with Better Technology
Behind every review is a team of skilled professionals and advanced analytical tools. Our technology gives you real-time access and easy-to-read reports while our team handles every detail with care so nothing is ever missed.
Incorporate bill review data with claims administration data base- Seamless integration with utilization management
- Utilization of state-of-the art software
- Cost analysis and customized reporting in your preferred format
Out-of-Network
Services
Although First MCO makes every effort to refer into our contracted network or to redirect into our network, there are times when an injured worker utilizes an out of network provider. In those situations, we negotiate directly with the non-contracted provider to secure fair pricing and eliminate unnecessary appeals and billing surprises.
Utilization
Review
Our clinical team confirms that all medical care is appropriate, timely, and necessary—so you’re only paying for what’s needed.
Pharmacy Benefit
Management
We simplify access to necessary prescriptions with a formulary designed for Workers’ Compensation.
At First MCO, we view bill review
as an opportunity to optimize your savings.
78% Negotiation Success rate,
57% average savings on negotiated bills
