Retrospective Review
Our comprehensive bill review determines medical necessity of procedures, admissions, and services not certified which occur prior to, or during the occurrence.
Bill Review & Nurse Audit
Our comprehensive review evaluates your billing through the following:
OMFS Adjustments
Duplicate Bill Verification
Reconsideration Management
Client Portal Access
State Reporting
Non-Fee Schedule Bill Repricing
Direct Pay Bill Management
eBill Compliance and Management
Utilization Review/
Pre-Authorization
TRS Utilization Review (UR) service delivers appropriate, clinically sound treatment recommendations that result in more rapid recoveries and cost effective outcomes.
Prospective Concurrent, and Retrospective Reviews
Pharmacy / Drug Utilization Reviews
National capabilities with licensures in appropriate jurisdictions
Evidenced-based national guidelines or state specific guidelines
National panel of credentialed, board-certified physicians
Peer reviews conducted by physicians of the same specialty
Single digit appeal rates in every state - significantly lower than industry averages
UR-Bill Reviews system integration with adjuster treatment alerts
Trinity helps you understand the value you’re getting, including:
Cost savings reports on denied / modified services - hard savings only
Compliance metrics by state measuring Utilization Review turnaround time
Early Compensability Assessment
A certified Trinity Doctor evaluates the first 7-10 days of medical information to determine compensability.
Impairment Rating Review
Trinity Review Physician Advisors review impairment ratings for appropriateness based on the diagnosis, and compliance with national guidelines.
Injury Severity Scoring
A Trinity Review Panel Doctor will evaluate whether Mild, Moderate or Severe determinations fall within the ISS scoring formulary.
Peer Review
Provides an independent and objective analysis by a practicing peer physician or medical provider, when the level or type of care is questioned.
Life Care Planning
Trinty Review, specially licensed as Life Care Practitioners, develops economic forecasts of medical needs. Life Care Plans periodically assess care, set reserves, and determine the most cost effective, medically necessary services based on life expectancy.
Additional Services
DWC 32 with Claims File Analysis, IRR Reviews, Cumulative Impact Analysis, Medicare Set-Asides, Drug Utilization Review, and ODG Review