Custom PPO Networks

There has been an overwhelming need in the workers' compensation arena for
quality custom PPO’s designed around the injuries that are prevalent in
the industry. Such a model offers successful, prompt, and affordable
solutions for our clients and their injured employees.

Employer’s Choice Network concentrates on the development and maintenance
of proprietary PPO’s for an array of self-insured employers, TPA’s,
insurance companies and managed care organizations. Our physicians,
hospitals, and ancillary providers are specifically selected by our
clients based on the highest quality of care, frequent communication, and
shared experiences.

Hospital Bill Auditing

Hospital bill audits can drastically influence your bottom line. There is
a 97% error rate nationwide! That is over 10 billion dollars a year in
overcharges from hospitals.

At Employer's Choice Network , our professional, clinical staff examines the
hospital bills line-by-line for duplicate charges and errors in billing.
A thorough audit is done to compare items billed against items ordered
which many times results in major variations. Anesthesia, recovery room
and OR times are also compared with medical records to evaluate the
accuracy of billed charges. Our staff is experienced in seperating charges
related to the workers' compensation injury versus charges billed for
treatment of unrelated items. Once all duplicate charges, errors, and
unrelated charges have been removed, the applicable fee schedule is
applied and a PPO discount is taken for additional savings.

Medical Bill Review

Employer’s Choice Network provides state-of-the-art bill review services
that encompass all 50 states' fee schedules and/or usual and customary
rates. We focus on fee schedule review, usual and customary review, drug
and supply charges, utilization review compliance with CPT guidelines,
bundling/unbundling, and elimination of duplicate billing. We are able to
receive medical bills by fax, mail and EDI exchange, while guaranteeing a
72-hour turnaround.

Employer’s Choice Network offers a variety of reporting to assure us and
our clients that our quality never falls behind. These same proactive
reports highlight areas where improvements can be made. These reports
measure our staff’s production, accuracy, and turnaround time as well as
give our customers the ability to access our system and run their own
respective reports.