Custom PPO Networks for Workers' Compensation

There has been an overwhelming need in the workers' compensation arena for quality custom PPO’s designed around the injuries that are prevalent in the industry. Such a model offers successful, prompt, and affordable solutions for our clients and their injured employees.

Employer’s Choice Network concentrates on the development and maintenance of proprietary PPO’s for an array of self-insured employers, TPA’s, insurance companies and managed care organizations. Our physicians, hospitals, and ancillary providers are specifically selected by our clients based on the highest quality of care, frequent communication, and shared experiences.

Hospital Bill Auditing

Hospital bill audits can drastically influence your bottom line. There is a 97% error rate nationwide! That is over 10 billion dollars a year in overcharges from hospitals.

At Employer's Choice Network, our professional, clinical staff examines the hospital bills line-by-line for duplicate charges and errors in billing. Thorough hospital bill audits are done to compare items billed against items ordered which many times results in major variations. Anesthesia, recovery room and OR times are also compared with medical records to evaluate the accuracy of billed charges. Our staff is experienced in separating charges related to the workers' compensation injury versus charges billed for treatment of unrelated items. Once all duplicate charges, errors, and unrelated charges have been removed, the applicable fee schedule is applied and a PPO (Preferred Provider Organization) discount is taken for additional savings.

Employer’s Choice Network offers a variety of reporting to assure us and our clients that our quality never falls behind. These same proactive reports highlight areas where improvements can be made. These reports measure our staff’s production, accuracy, and turnaround time as well as give our customers the ability to access our system and run their own respective reports.

Medical Bill Review for Workers Compensation

Employer's Choice Network provides medical bill review services for workers compensation that encompasses all 50 states' fee schedules and/or usual and customary rates. Our medical bill review focuses on fee schedule review, usual and customary review, drug and supply charges, utilization review compliance with CPT guidelines, bundling/unbundling, and elimination of duplicate medical billing for workers compensation. Our medical bill review for workers compensation is done by fax, mail and EDI exchange, guaranteeing a 72-hour turnaround.