Provider Bill Review
This premier service combines current state fee schedule revisions with the latest database for usual and customary charges to eliminate excessive and duplicate charges. In addition to insuring your regulatory compliance, bill review identifies billing infractions that might normally get lost in the shuffle, while customized rules make it easy to identify and divert predefined bills for specific injuries and procedures to a nurse case manager for review and challenge.
Preferred Provider Organization Networks
Our unique PPO strategy grants you special access to numerous national, regional and proprietary networks. We can also customize each specific program by incorporating client-negotiated provider discounts. This mosaic approach provides optimal network coverage with maximum savings, giving you more for less.
Specialty Bill Review
Specialized medical procedures can lead to exorbitant bills and excessive charges. This unique service uses robust data from more than 20 public and proprietary sources to provide the legal, medical and financial bill analysis required to ensure a re-pricing review that’s fair, reasonable, defensible and unique to your jurisdiction.
Integrated Pharmacy Program
Prescription drug costs now account for 12% of total medical claims. And they're on the rise, climbing faster than general medical inflation. Through Comp RX — an integrated pharmacy program linked directly to our proprietary claims software, we can capture "first fills" and adjudicate pharmacy claims directly online when they're dispensed. Studies show that first fills account for 80% of all pharmacy costs; therefore, any successful program must capture this event.
Our adjusters also have the ability to look up data from the pharmacy, doctor and patient via one screen, bringing together all the data required to make informed and cost-effective decisions. With this system in place, we can view drug information and pricing, recent reject history, recent claim history, and approve medications — all in real time, delivering the best care at the lowest cost.
At CCMSI, we realize that proactive nurse case management can lower cost, improve care and help injured employees return to work sooner. Whether you use our proprietary nurse case management resources (available in select offices) or a preferred partner, we'll work with the nurse involved to establish and oversee a medically appropriate and cost-effective treatment plan to achieve optimal results.
Analysis and Savings Reports
For the best results, you need objective and definitive data to measure the success of your managed care program and fine-tune future performance. That's why we offer a full library of reports, allowing you to gauge any number of variables.
I have been pleased with how your IT folks will customize programs for their clients if it makes sense, and they can make it happen. From the first time you demonstrated the Ice System in the summer of 2008, until now, I have maintained it is the most user friendly system I have used.John CostanzoCoca-Cola Bottling Company United
I have used CCMSI’s claims system (iCE) for many years. iCE is top notch technology! It is by far the best software program in the industry and very user friendly. We can summarize our claims data or analyze it to the most detail we want. Our Risk Managers use to spend hours on their OSHA log and summary. The OSHA program in iCE has been one of the best features for us. Our 300 logs and summaries are just a click away!Barb CrammondDirector Corporate Risk Management
I am thoroughly impressed with iCE. It is the most user friendly RMIS system I have ever worked with. And I have worked with them all up until CCMSI.Benjamin Wines-BrackettClaim Account ExecutiveRisk Solutions Group
McGRIFF, SEIBELS & WILLIAMS, INC.
5605 Glenridge Drive, Suite 500; Atlanta, GA 30342
Controlling our workers’ compensation costs are a crucial factor in our claims management strategy. Our team finds the CCMSI employees, system and services to be fast and efficient. We cannot express how impressed we are with the claims handling and the quality of service they provide.Denise K EvansDirector of Workers’ Compensation ClaimsStaffmark
We have experienced significant value in our auto and general liability and workers compensation as a result of an exceptional claim team and best practices through our partnership with CCMSI.Mack Savage, Vice President Corporate InsuranceJohn Bradley, Senior Vice President, Corporate InsuranceUS Bank
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Having trouble getting the data you want on your system? If your systems are falling flat, dragging on efficiency, accountability, and organization - let us know and we can arrange onsite demonstration and education sourced from 30 years of experience