BillChek®

HELPING PAYERS FIGHT MEDICAL BILLING FRAUD AND EXCESS COSTS
BillChek
®
BillChek® is an innovative program designed to maximize out-of-network medical bill savings,
helping to drive costs down and savings up while providing supportable recommendations for
carriers and other medical bill claims payers
Bill types
•
Ambulatory surgical center
•
Emergency room
•
Inpatient hospital
•
Outpatient hospital
•
Ambulance
•
Provides greater savings than “prompt pay” methods
•
Focused on fair reimbursements to both payers and providers
•
Patent-pending software leverages proprietary and public data analytics
•
Methodology supported by physician-based expertise
•
Recommendations supported by Qmedtrix-led dispute resolution team
•
Concise recommendation summaries
•
Bills received via electronic data interface (EDI), secure email, fax or mail
BillChek® is grounded in a fusion of human and
artificial intelligence.
•
Excessive hospital charges triggering
outlier or stop-loss thresholds
The Qmedtrix algorithm-based methodology
calculates appropriate facility and ancillary
medical payments using data from public
and private sources. BillChek® is available for
out-of-network workers’ compensation and
automotive medical claims bills.
•
Fragmented charges
•
Medically-unlikely procedures
•
Unreasonable procedure charges
To identify savings opportunities and fairly
reimburse providers, Qmedtrix reviews each
state’s specific statutes, regulations and case
law, analyzing data for changes in billing
patterns and trends.
BillChek® identifies and corrects:
•
Unbundling – separate billing-related
services
•
Upcoding – using “trauma” or “with
complications” to exempt charges from fee
schedules
•
www.qmedtrix.com
© 2014 Qmedtrix Systems, Inc.
Duplicate charges, particularly when billed
under separate codes
BillChek® recommendations are supported by
Qmedtrix-led dispute resolution team. Provider
inquiries, reconsiderations and dispute
resolution support services can be included
in the cost of the services, depending on
agreement terms.
The Qmedtrix methodology incorporates
historical data, a physician-based expert
knowledge of medical procedures and billing
practices, and extensive legal and regulatory
due-diligence to deliver accurate and
reasonable payment recommendations.
To talk to a Qmedtrix representative, please
contact us at info@qmedtrix.com.
Our people have helped place us again
among a distinguished list of companies.
Portland’s Grant Thornton LLP is
ranked fourth among large companies
in Oregon Business Magazine’s 2009
100 Best Companies to Work For
in Oregon list.
Read all about it at
www.Oregon100Best.com
Other recent recognitions have included:
●
●
●
One of the 100 best companies for working mothers
by Working Mother Magazine (2006-2008)
Business Week’s “Best Places to Launch
a Career” for new college graduates (2004-2008)
2008 Honor Roll by The Center for Companies
That Care
●
PINK’s Top Companies for Women in Business
(2007-2008)
●
Computer World’s Best Places to Work in IT (2006-2008)
Find out what it’s like to work with people
who love what they do.
In Portland, please contact:
Gary Homsley
Location Managing Partner
T 503.276.5903
E Gary.Homsley@gt.com
Tony Parke
Audit Partner
T 503.276.5930
E Tony.Parke@gt.com
Rob Nicklos
Audit Partner
T 503.276.5944
E Robert.Nicklos@gt.com
Scott Remington
Tax Partner
T 503.276.5907
E Scott.Remington@gt.com
Doug Watson
Business Development Executive
T 425.246.8708
E Doug.Watson@gt.com
Audit ● Tax ● Advisory
www.Grant Thornton.com
© Grant Thornton LLP
All rights reserved
U.S. member firm of
Grant Thornton International Ltd.
For more information: www.oregonwomenlawyers.org
RSVP Reception only: linda@oregonwomenlawyers.org
Email ___________________________________________________________________
Phone ____________________________
City/State/Zip ____________________________________
Bar Number _____________________________
q Late Registration fee after May 30 ($15 extra)
q Students ($35)*
Address _________________________________________________________________________________
*Student registration price does not include a copy of book.
Firm/Organization ________________________________________________________________________
Public Reception and Book Signing,
Miller Pavilion
Name ______________________________________
5:00 pm
*Student registration price does not include a copy of Betty Roberts’ book.
CLE and Panel Presentation, Madison Room
Register by sending this form and your payment (checks only) payable to: Oregon Women Lawyers by May 30 to:
Oregon Women Lawyers, PO Box 40393, Portland, OR 97240
3-5:00 pm
q OWLS Members ($75) q Non-OWLS Members ($90)
2008 OWLS Spring CLE
Friday, June 13, 2008, 3:00 PM
Public Reception, 5:00 PM
Oregon Historical Society
1200 SW Park Ave, Portland
Immediately following the CLE, OWLS members and
the public are invited for a book signing and reception.
Justice Roberts will read an excerpt from her memoir,
which will be available for sale. Reception includes hors
d’oeuvres and a no-host bar.
Public Reception, 5:00 - 7:00 PM
An autobiography
release CLE
and reception
Two panels will discuss the
themes and events in Justice
Roberts’ groundbreaking
book, and the evolving
role of women in Oregon’s
political, legal and social
landscape. Panelists include
Justice Roberts, former
state legislators Norma
Paulus and Gretchen
Kafoury, Justice Virginia
Linder, Judge Adrienne
Nelson, and a#orneys Liani Reeves and Cashauna Hill;
PSU Political Science Department Chair Melody Rose
will moderate. MCLE credits pending. Registration fees
include a copy of the book.*
Friday, June 13, 2008 3:00 - 5:00 PM
With Grit
And By Grace:
Breaking Trails
in Politics
and Law
With Grit And By Grace: Breaking Trails in Politics and Law
I
n 1955, Be y Roberts le! behind a homemaker
lifestyle to find fulfillment in an inspiring and varied
career that included practicing law, serving as a legislator, and eventually becoming the first woman appointed
to both the Oregon Court of Appeals and the Oregon
Supreme Court. Join Oregon Women Lawyers to celebrate
Justice Roberts’ life and career at a CLE and reception
marking the release of her autobiography, With Grit and
By Grace: Breaking Trails
in Politics and Law.
Title Sponsor:
www.oregonwomenlawyers.org
PO Box 40393
Portland, OR 97240
The evolving
role of women
in law: the life
and career
of a Lawyer,
Legislator, and
Supreme Court
Justice
Friday, June 13, 2008
Portland, OR
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PAID
PRSRT STD
U.S. Postage