Departmental Integration

All of our systems are integrated. We communicate information at the claim level via a shared notes system. Bill review history as well as current data is captured and maintained indefinitely. Case managers provide routine updates on open cases. Peer Review reports are all scanned and stored and available for reference to all departments. Preauthorization results are all scanned and stored as well. Department managers meet regularly to address any specific concerns. All information is shared to optimize our collective efforts and help our clients manage claims to contain costs.

EDI Capability

Review Med has EDI capabilities that support a completely automated process where all payment, EOB and fee data is electronically transmitted to the client by secure, HIPPA compliant EDI interface. We are also able to support a completely manual process returning completed bills with paper EOBs and invoices in hard-copy. We are able to tailor a Bill Review program that meets the specific needs of our clients.

Implementation

Implementation is critical to the success of any program. Ultimately, success is defined by our clients and their overall satisfaction level. Every implementation is a custom implementation. Because of this, we manage it carefully and dedicate all necessary resources. Review Med and our technology partner work in collaboration to manage every component and task of implementation. We develop a comprehensive implementation plan with reasonable goals. We share this plan with all responsible parties internally and with the client and keep it current with daily and weekly updates. We work together to ensure the least impact on the client’s staff. We strictly manage time frames for completion. We include testing and confirmation as a routine part of each task. These are the critical steps that have proven successful in our implementation process.

Components of the implementation include:

  • Completion of EDI integrations in an accurate and timely manner
  • Accurate loading of historical bill review data
  • Testing of all EDI processes and verification of data integrity
  • Operational implementation including addressing any staffing and equipment needs
  • Client collaboration at every level of staff to ensure a thorough understanding of all services and workflows.