Maintaining compliance with each state's unique legal requirements demands extensive professional and financial resources. Legislative changes as well as routine and ad hoc changes to state and Centers for Medicare & Medicaid Services-based fee schedules, billing rules and billing guidelines have an impact on an organization's ability to remain compliant.

In an ever changing re-pricing landscape, payors must not only stay abreast of these mandates, but also ensure the timely and accurate implementation of software and process updates to put the required changes into place. In 2012 alone, jurisdictions made over 200 changes to their fee schedules and related rules for payment of medical bills.

At Bunch CareSolutions, our team of compliance experts includes clinical and non-clinical professionals—medical directors, physicians, nurse case managers, bill review and regulatory compliance specialists—to interpret state regulations and apply required changes to our bill review software and workflows for proficient bill review, validation and auditing functions and state reporting.

Bunch CareSolutions compliance experts also administer our MCO/MCA programs and oversee the administration of our California MPN, Texas HCN and Texas Non-subscriber programs.