Proprietary Technology

Bunch CareSolutions utilizes a sophisticated and proprietary bill processing system, Citadel,  which integrates claim demographic information, compensability information, carrier status, adjuster payment direction, nurse case management payment direction, tabular and non-tabular fee schedule reductions, broad-based PPO and specialty network interfaces.The system also manages out-of-network negotiations for below fee schedule reductions to ensure the payment is accurate and savings are maximized.

When state-mandated reimbursement rates are not automated, Bunch CareSolutions has developed its own business rules to identify bills that may be candidates for additional reductions. Bills captured by our customized rules are manually reviewed to ensure that they are reduced as permitted by state guidelines.

Below Fee Schedule Reductions

We realize the many benefits of strategic partnerships with medical providers and the vast savings that can be achieved through these relationships to help control medical costs. As a result, Bunch CareSolutions strategically partners with over 200 different specialty networks and all of the major broad-based networks to offer employers the highest level of flexibility.

We support a variety of network configurations, which can be set by the client, state of jurisdiction, or bill type to yield the best possible outcome for cost control. After bills are reduced to state fee schedules or usual and customary rates, the system applies client-specific contracted rates and routes bills to specialty or broad-based networks to obtain improved discounts.

Out-of-Network Negotiations

To further control costs, bills categorized as out of network are also evaluated by the negotiation team for further discounting. Leveraging both prospective and retrospective network alignments, Bunch CareSolutions is able to achieve a vastly superior outcome in below fee schedule reductions.