CHN PPO solutions can be stand alone or bundled with our parent company's Medlogix Medical Bill Review services
Seamless integration & automation within MyMedlogix Software, our proprietary, web-based case management and bill review software.
- This integration allows us to provide bill review and PPO network decisions that are linked seamlessly, enhancing staff efficiency and productivity for our clients.
- Processing for bill review, negotiation, and claims management, including scheduling, EDI, PPO rate application, and case management.
- Supports multiple lines of business: Auto (PIP), Workers’ Compensation, and Group Health.
In-house Review from our PPO Rate Application Team
- Applies contracted rates after considering state fee schedules and UCR (Usual, Customary & Reasonable), ensuring consistency and accuracy.
- Real-time analytics via MyMedlogix provide actionable insights on provider usage, cost trends, treatment patterns, overspend, and return-to-work rates.
- Detailed reporting and procedure-level cost tracking are available to monitor utilization and performance trends.
PROVIDER BILLS ARE PROCESSED WITH LESS THAN A 1% APPEAL RATE, REFLECTING OUR HIGHLY ACCURATE REPRICING AND CONTRACT APPLICATION.
Bill Review & Negotiation Process
Bill
Received
Received
Bill
Review
Review
PPO
Contract? Yes No
Contract? Yes No
Out-Network
In-Network
Bill
Negotiation
Negotiation