File Review - Designed to Attain Maximum Network Penetration
The Cypress Care File Review Service equips our clients with a mechanism to ensure that cost management goals are met and that potential savings are maximized. We maintain a staff of qualified professionals who work on-site with our clients at no cost to review files and identify all applicable cases for referral to Cypress Care. This service is expressly designed to prevent any additional effort for adjusters. Each file is examined for cost containment opportunities in the areas of medications, DME, TENS and supplies. Our file review methodology identifies and qualifies those files where maximum savings can be realized for our clients.
The File Review Service is composed of two discrete processes: Initial File Review and Ongoing File Review. The Initial File Review is a one-time review to identify any current open files where claimants are eligible to be converted to the Cypress Care program. The Ongoing File Review is conducted to capture new claimants as they are identified by the system.
Cypress Care offers a thorough review to identify and recruit outstanding claimants. In the event that a pharmacy bill for a qualifying claimant on an accepted claim for authorized medications is identified within the prior thirty (30) days, Cypress Care will take the pharmacy bill, contact the pharmacy directly to have it reprocessed at our reduced rate. We will pay the bill on our client's behalf and re-bill the claim at the reduced contracted rate. The claimant will then be sent a prescription card for future medications to be billed directly through the Cypress Care program.
Contact a Cypress Care representative to learn how we can assist your organization in attaining maximum network penetration.