Payment Integrity
Carisk’s Payment Integrity program contains the costs of workers’ compensation medical bills through its evidence-based analysis, proprietary software, and advanced clinical negotiation, delivering savings beyond industry standards.
Employing a strong Payment Integrity strategy reduces fraud, waste and abuse and ensures accuracy and trustworthiness of workers’ compensation medical payments. Carisk achieves average savings of 50% across a range of claim types with specific case savings over 90%.
Resources
Payment Integrity
Carisk’s Payment Integrity program contains the costs of workers’ compensation medical bills through its evidence-based analysis, proprietary software, and advanced clinical negotiation, delivering savings beyond industry standards.
Employing a strong Payment Integrity strategy reduces fraud, waste and abuse and ensures accuracy and trustworthiness of workers’ compensation medical payments. Carisk achieves average savings of 50% across a range of claim types with specific case savings over 90%.
Comparative Analysis
In addition to the clinical claims audit, Carisk utilizies reference points such as PPO Network negotiated rates, Medicare, Fee Schedule and Usual and Customary Rates to understand the performances of the program. The following real-word examples are representative of and consistent with Carisk’s overall program performance.
Carisk Payment Integrity Savings
Example Across Facility and Procedure Types
![CP_PaymentIntegrity_Examples_Website_01](https://www.cariskpartners.com/wp-content/uploads/2024/07/CP_PaymentIntegrity_Examples_Website_01.png)
Hospital Inpatient
Non-Fee Schedule Example, Negotiated Rate Consistent with Medicare and 39% off PPO Discount and UCR
![CP_PaymentIntegrity_Examples_Website_02](https://www.cariskpartners.com/wp-content/uploads/2024/07/CP_PaymentIntegrity_Examples_Website_02.png)
Carisk Payment Integrity Services
Facility Bill Negotiations
Inpatient and Outpatient Bill Negotiations for facility, physician, and medical equipment fees
Surgical Bill Negotiations
Unparalleled savings on surgical implants, prosthetics, device implants, and joint replacements
Pre-Negotiations
Reconciliation in advance for rehab/long term care, surgical procedures, and
air ambulance transfer
Demand Package Review
Independent summary of injured workers
case for settlement services
Lien Negotiations
Resolve liens and validate
legitimate disputes without litigation
Ensure Payments are Legitimate, Accurate and Compliant
Expert Analysis
Every bill is forensically reviewed
identifying all negotiation points
Credentialed Negotiators
Clinical nurses with hospital experience
and coding certifications complete
all negotiations
![Long-TermRelationshipsIcon](https://www.cariskpartners.com/wp-content/uploads/2024/07/Long-TermRelationshipsIcon.png)
Long-term Relationships
Carisk negotiators maintain professionalism
and integrity throughout the negotiation
process. This ensures strong provider
relationships and durable results.
Contact Us
Request a Demo