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Workers' Compensation


Managed Care Services


We help achieve the highest level of medical savings and payment integrity through innovative cost containment solutions.

We’ll partner with you to

  • Exceed your savings goals with proprietary technology and exceptional professional support
  • Strengthen your review results with state- and industry-specific expertise
  • Maximize care access and in-network utilization with leading network strategies
  • Support your program stakeholders with experienced customer service resources

Our managed care program

Comprehensive medical bill review

  • eBill or paper bill intake
  • Mailroom processing
  • Fee schedule/UCR application
  • Expert rules, audit, and negotiations
  • PPO networks
  • Customized auto-adjudication
  • Utilization management
  • Customized EDI and reporting
  • Customer support line

Expert rules, audit, and negotiations

  • Unique platform-independent solution
  • Dynamic Clinical & Coding Logic (CCL) rules
  • Dynamic TrueCourse (Wisconsin-specific) bill review
  • Clinical and coding expertise
  • Out-of-network negotiations
  • Customized reporting
  • Compliance, regulatory, and state-specific expertise

PPO network offering

  • National coverage for maximized access
  • Customizable network to meet client-specific needs
  • Simplified administration
  • Ongoing data validation
  • Provider panels and lookup tools
  • Dedicated customer service team

Clearinghouse and payment services

  • Fast, accurate, secure web-based eBilling
  • Online, standardized communication
  • Paper-to-electronic conversion
  • Web-based document management
  • Highly configurable payment platform
  • Extensive ePayment networks
  • Mutiple, layered fraud detection

Explore our other workers' compensation solutions

Pharmacy Care Services

Ancillary Services

Settlement Solutions