Medical Cost Review

MCR

We provide a fair & rational approach to ensure that medical services are paid at a reasonable & fair rate.  We eliminate abusive billing and thrive on accuracy.

 

Key Services

Expert Witness Testimony

Leverage expert insight to challenge medical billing and support your legal strategy.
 Our certified billing and coding experts provide independent, trial-ready testimony to defend or dispute medical charges in Workers’ Comp, liability, and civil cases. We blend decades of real-world experience with analytical precision to deliver clear, credible, and persuasive courtroom support.

  • Trial-Ready Reports & Exhibits – Every opinion is backed by thorough documentation and professionally presented exhibits designed to hold up under scrutiny.
  • Defense and Plaintiff Support – Whether you're reducing exposure or defending provider billing, we provide unbiased, data-driven analysis for either side.
  • Courtroom Credibility – Our experts are recognized across jurisdictions for their billing accuracy and technical fluency in complex medical cost matters.

Specialist-Compiled Medical Bills

Turn scattered, confusing medical bills into a single, coherent, and accurate financial picture.
 We gather all billing documents related to a case—no matter how complex—and produce a streamlined report with detailed audit insights. This service is ideal for attorneys, insurance carriers, and TPAs managing multi-provider, multi-treatment claims.

  • Full Case Bill Compilation – Centralizes all submitted charges into one clearly formatted document for easy reference.
  • Unbundling and Coding Audit – Identifies improper CPT/HCPCS coding, upcoding, or duplicated charges that inflate costs.
  • Insurance-Adjusted Analytics – Applies UCR, fee schedule, and payer contract benchmarks to determine actual allowable amounts.

Bill Negotiation Services

Drive down inflated claim values with intelligent, assertive negotiation support.
 Our seasoned negotiators work directly with medical providers and lienholders to resolve billing disputes—often achieving significant savings. Every offer and counteroffer is backed by data, precedent, and a strong understanding of both sides' motivations.

  • Comprehensive Lien Settlement Services – We handle all communication, documentation, and settlement logistics.
  • In-House Negotiation & Documentation – Our team prepares detailed briefs and tracks every step of the negotiation process.
  • Data-Supported Counteroffers – Proposals are built on accurate reimbursement data, allowing us to justify substantial reductions.

Other Key Capabilities

Medicare Set-Aside (MSA) Analysis and Reporting

  • Reduce liability and ensure CMS compliance through detailed MSA projections.
  • Our experts evaluate treatment history and future medical needs to deliver defensible, CMS-approvable reports, including structured settlement guidance.

Fraud Investigations and Background Analysis

  • Expose suspicious claims with licensed investigations and in-depth analysis.
  • From surveillance to employment verification, we provide full-scope fraud detection and support legal efforts with evidence-based reports.
Medical Cost Review

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