Bunch CareSolutions uses a re-pricing engine to apply appropriate parameters to ensure proper bill reduction and uses proprietary business rules to identify bills with potential for further reductions. As a bill progresses through the re-pricing phase of the bill review process, Bunch CareSolutions applies state fee schedules, usual and customary reductions, network re-pricing, and clinical edits.

Our network philosophy centers on the principle of accessing multiple broad-based PPO networks, specialty networks and pharmacy benefit management partners. Our system leverages all integrated data elements and routes bills to specialized queues for targeted review. As a result, we are able to dramatically extend the scope and capability of our medical bill review platform.

With our proprietary applications, we can apply customized logic and hundreds of business rules after normal bill review functions are complete to identify medical bills with over-utilization or unusual billing practices. After all automated bill re-pricing edits have been applied, our system moves the appropriate bills to a specified queue for further review by a senior processor, state expert or licensed utilization review nurse.