WORKERS' COMPENSATION
SOLUTIONS
Melody™, WellRithms medical bill review technology, delivers a comprehensive suite of solutions that augment existing bill review services to address industry gaps, increase savings, & improve cost containment outcomes.
Experience Speciality Bill Review That Delivers Guaranteed Savings.
Significantly lower medical expenses with our innovative solution for bills not subject to state fee schedules.
WellRithms engine reprices bills to a reasonable industry standard using multiple validation standards to ensure fair reimbursement that is legally defensible and backed by case law and evidentiary standards across all jurisdictions.
Our goal is not just to lower your overall healthcare spend, but to provide a sustainable solution for you.
WellRithms' repricing across service type in the following states.
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.
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!
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!