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Cost Containment

Reducing Your Claims Costs is Our First Priority

Find savings strategies for Bill Audits, Negotiations, and Reference-based Pricing. AMS offers complete services to find where your claims costs can be reduced.

Bill Auditing Services

By performing a physician-led comparison of the client’s hospital bill information against the AMS database of medical billings from all 50 states and the District of Columbia, we help you determine whether the bill is charged appropriately or if you are asked to pay more in error. Drugs, supplies, and DME charges are some of the areas we critically review to maximize your savings.

Our Bill Auditing Services include:

Comprehensive reporting that examines all related Provider records and identifies areas for bill reduction. By validating the bill charges against the medical record, we can determine appropriateness of treatment services rendered.
Precise, Physician-led reviews that evaluate bills by checking for inflated treatment charges, unbundled charges, whether charges are eligible based on UCR language within the plan document, and general billing errors, like duplicate charges.

Negotiations

AMS physicians will directly negotiate discounts for inpatient facilities and physician charges. By leveraging our clinical expertise regarding drug application and medical treatment plans, we are able to win our clients 25% discounts on average and significantly decrease claims costs. AMS has forged quality relationships with many of the nation’s leading hospitals and healthcare facilities, and our reputation for fairness and integrity makes it possible to achieve unsurpassed results in medical bill negotiation efforts. Negotiation services are available to Stop-Loss Carriers, Reinsurers, HMOs, Attorneys, Third Party Administrators, self-insured groups, and governmental agencies.

Key Benefits:

i

Usually resolved within 10 business days

ii

Full release from liability

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Patient cannot be balance billed

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Results in significant “no hassle” savings

Medical Negotiations

Reference-Based Pricing

What is Reference-Based Pricing?
AMS can perform the calculation of allowed benefits on plan documents that present charges as a percentage of Medicare rates or another defined pricing mechanism. These calculations can be made as an alternative to traditional PPO discounts, and may yield further savings.

Are You Missing Out On Savings?
Many TPAs and MGUs simply don’t have the time or resources to perform a thorough Reference-Based Pricing check. As a result, opportunities to to reduce payor liability are missed, and savings are lost. For payors who cannot make this calculation, AMS offers the service at a lower rate than our competitors. We believe that when handling high dollar and complex claims, you should have a resource that you can count on to deliver savings.

How to Get Started
Take advantage of our Reference-Based Pricing service and get your lowered rate today. Fill out the form on this page for a complimentary, no-cost screen of a specific claim. After we review your claim, we’ll tell you just how much we can save you – and the surprisingly low portion of that amount that we would retain as our fee.