WORKERS' COMPENSATION
SOLUTIONS
Maximize savings with fair and defensible reimbursement.
Experience Guaranteed Savings with Melody™ by WellRithms: Your Solution for Accurate Medical Bill Pricing
Melody™ by WellRithms is a comprehensive solution for workers' compensation payers looking to stop overpaying for healthcare. Our suite of products, including Shield Indemnification, Sustainable Bill Pricing (SBP) for UCR States, and Stop Loss Outlier, are designed to achieve the most accurate pricing for medical bills with guaranteed savings.
BOLD | SMART | PROGRESSIVE | HUMAN | EXPERIENCED
Significantly lower medical expenses with our innovative solutions for bills not subject to state fee schedules. Our itemized bill editing, using advanced physician clinical audits, along with our proprietary algorithms for line-by-line repricing, guarantees fair and defensible reimbursements while delivering savings of 60-80% off the billed amount.
State
Facility Bills
Professional Bills
AZ
IA
MO
NH
NJ
PA
UT
YES
YES
YES
YES
YES
TRAUMA ACTIVATED*
YES
YES
YES
YES
YES
YES
* Initial in-patient stay at Level I and II
trauma center and in-patient rehabilitation
at acute care hospitals.
Air/Ground Ambulance bill repricing in 20 states that do not have a fee schedule:
AZ, AR, CA, FL, ID, IA, KS, LA, MO, MT, NE, NV, NH, NJ, NM, NY, OR, UT, VA, WI
Our itemized bill review services are designed to help achieve average savings of 40% on every bill, with a 100% guarantee on our savings. Outlier rules in certain fee schedule states mandate that bills at predetermined thresholds be paid at a percentage of total billed charges instead of the normal fee schedule rate. Melody™ by WellRithms ensures that payers are not overpaying by manipulating the system.
Unfortunately, some providers take advantage of outlier rules by using inflationary billing tactics to increase prices and secure higher payments. Payers unknowingly lose millions of dollars annually through this problematic loophole. Our team at WellRithms exposes these overcharges and ensures the allowed charges are accurate. Allowed charges are significantly reduced before the outlier adjustment is applied.
Our process is designed to remove services that are incidental, bundled, or included in the primary procedure. Also, we ensure charges are consistent with the hospital's reported costs submitted to the Centers for Medicare and Medicaid Services (CMS).
With Shield Indemnification™, Health Plans never have to worry about overpaying. Our guarantee ensures that you never pay more for your claims – guaranteed!
