CLMC's nurse experts and expert certified coders conduct utilization reviews and/or medical bill audits to determine whether the healthcare providers’ fees are usual, customary and reasonable, and if not, reduce the fees to the prevailing charge for the specialty in the geographical locale.  They  determine whether the charges were duplicated, not performed, or charged inappropriately, and if so, reduce the fees accordingly.  We also offer subrogation services to minimize loss ratios.  Personal injury claims and litigated cases have historically been reduced by millions annually.

A Skilled Observation Makes the Difference

                                            

Analyze   A comprehensive, forensic, expert review of records with particular attention to minute details that will determine whether the case has merit, and if so, any contributing factors or causes that may mitigate your client's damages. Medical records and medical bills will be manually scrutinized to determine whether treatment was necessary, irrelevant to the injury, whether the itemized bill was appropriately charged to the usual, customary and reasonable fee, whether it was upcoded, bundled, duplicated or services not performed.

Management

A single source of data sharing cost-effectively provides critical information required to make accurate decisions. Featuring a state of the art, protected and secure, information management system that allows you to login and view reports on each claim or case detailing recaptures and fee reductions.

Programs

Software programs that instantly calculate the usual, customary and reasonable fee for any specialty in any geographical area for any case and any date of loss.  These software programs are updated annually or as new regulations become effective.