Up to 90% of all claims billed by hospitals have errors, and claims payment systems catch only a fraction of these mistakes. This is proof that medical claims billing is far too complex and has only gotten worse since the industry-wide move to ICD-10 coding. We believe that billing errors are one of the largest drivers of unnecessary healthcare cost.
Continental Benefit’s Medical Bill Review (MBR) process provides a solution to this.
We review claims over $15,000 for fraud, waste, abuse, coding accuracy, medical record documentation, clinical appropriateness, and reasonability of charges, which not only reduces payments but also helps hospitals correct recurring billing errors. All audits and payment reductions are made prior to making payments to the provider.
The outcome? Not only do we apply the largest and best carrier discounts, we find an additional 6-10% claim savings costs on average for each in-network claim. For out-of-network claims, the average billed charges are reduced by 67%. Because of our MBR process, clients save between 2-4% on their total annual medical spend.