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Medical Case Studies - Reviews ; Audits; Investigations

Through our medical consulting services we have encountered various problems and situations that can be found throughout the following case studies. These studies are to help you understand how we tackle certain situations and how we render opinions about certain medical bills or claims.

By clicking on the following case studies you will see the various client cases we have analyzed. These examples of extreme cases show how claims can be overpriced, duplicated, medically unnecessary, experimental or investigational procedure or there's a need of underwriting reviews. We look at the actual costs of the procedure, the need of the procedure and if the procedure was experimental or not. Through this process we can pinpoint problems and create a possible solution. Some of these cases have us cutting costs by nearly $500,000 on one claim. This kind of cost containment can create a better and efficient health care system.

We sift through all the given information of the case to find problems or other issues that can be buried within the lines. These cases are just examples of what we can do with your claims and how our medical consulting services can help curtail catastrophic claims and costs.

Clinical:
Case Study 1: Medical Necessity Review
Case Study 2: Experimental / Investigational Review
Case Study 3: Experimental / Investigational Review
Case Study 4: Accidental Death Review
Case Study 5: Medical Underwriting Review
Case Study 6: Medical Underwriting Review
Financial:
Case Study 7: Provider Negotiations
Case Study 8: Hospital Bill Audits
Case Study 9: Provider Negotiations
Case Study 10: Hospital Bill Audits
Case Study 11: Hospital Bill Audits
Case Study 12: Hospital Bill Audits

 

 

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