TOXICOLOGY LABS

CHALLENGE

  • Excessive toxicology labs billed

SOLUTION

  • Questioned the medical necessity and frequency of the lab tests
  • The concern was forwarded to the administrator’s Special Investigations Department (SID) for further review
  • Medical records were requested from the provider

CLIENT WIN

  • SID identified 50 claims that needed adjustment
  • Request for provider refund was initiated

Estimated Recovery of
$66,033