Medical Review Software

Medical review software is used by medical bill payers to review health care bills. Medical bill payers like insurance companies are aware that medical billing procedures can be complicated and that health care bills include expensive billing errors.

Statistics

• According to Medical Review Solutions, 97 percent of hospital bills contain an error. Medical Review Solutions states these errors total more than $10 billion annually. Medical review software should eliminate a great deal of these billing issues.

Uses

• Health care professionals and insurance companies can use medical review software.

  Claims professionals, utilization review professionals, private practice workers and case management professionals can all benefit from medical review software. Medical review software can help these professionals with health care claims, court appeals, billing and pre-authorization requests.

Professional Review Services

• Professional medical reviewers and auditors are likely to use medical review software. The rise of patient advocacy groups for Medicare patients has translated into more member appeals and litigation. Payer organizations increasingly resort to external medical reviews provided by professional reviewers, who may use medical review software.