Maximizing Savings

With the combination of our experienced medical bill analysts, nurses and state of the art technology Novare is able to deliver maximum savings. Our Bill Review services can be customized to client specific business needs. Novare offers the flexibility to create specific business rules and apply those rules to assist in creating a more streamlined process. Our hands on approach ensure open communication with all clients during every phase of the Bill Review process. By offering a winning integration of multiple elements we are able to offer a powerful total savings solution.

  • Medical Bill Review
  • National PPO and Specialty Network Offerings
  • Out of Network Negotiations
  • Specility Bill Review

Medical Bill Review

Novare achieves maximum savings by applying multiple reductions elements.

  • Workers Compensation State Fee Schedule and Usual and Customary discounts: Novare applies all fee schedules reductions and billing ground rules to each medical bill, as set forth by each state to capture the greatest reductions for our customers. In states that no fee schedule exists Usual and Customary reductions are applied to combat excessive and over utilized charges.
  • Detection of duplicate charges Novare detects not only “true duplicates” but duplication of concurrent care is also detected.
  • Detection improper billing Each bill is audited for any improper billing practices such as coding, unbundling of services or any non-compensable charges during the Bill Review process.
  • Customization of specific business rules The ability to create specific business rules to streamline the bill review process guarantees the application of any client’s specific needs.
  • Integration of Utilization Review Decisions With real time integration of Novare’s UR module detection of all non -authorized treatment is seamless. This real time integration allows for a fast application of any unrelated or non- covered charges by our skilled team of bill analysts.

National PPO and Specialty
Network Offerings

Novare can deliver significant reductions below worker’s compensation fee schedules and usual and customary rates through integration of state-specific networks such as a Texas HCN and our access to multiple provider networks based on each individual client’s need. We can perform network analyses to identify any opportunities which could maximize overall network savings.

Out of Network Negotiations

Novare provides out-of- network negotiations using an experienced, professional staff. Customized solutions can be created to fit each client’s needs and includes signed agreements from the medical providers.

Specialty Bill Review

To combat excessive charges Novare provides a specialty Bill Review service that consists of in depth audits of any complex medical bill. Our staff reviews all CPT/HCPCS codes and the associated medical records to verify that they correlate with the level of charges billed. Clients are able to customize a program that fits their needs and that will achieve the most cost savings. Our staff consists of experienced auditors and a nursing staff who strive to achieve best results for all clients.

Case Management

Novare provides best practices that help injured workers and reduces employer cost

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Utilization Management

We use licensed nurses and board certified physicians helping maintain cost.

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Medical Bill Review

Utilizes automated bill review software to maximize potential reductions for authorized payments.

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MSP Service

Compliance driven solutions with personalized

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