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Medical Bill Review
Specialty Bill Review
Hospital Bill Review
Provider Negotiations
Utilization Management
Utilization Review
Care Management
Surgical Care Program
Physician Pharmacy Review
MSA Administration
PPO Networks
Provider Payments
Payer Web Portal
RI Work Comp Fee Schedule
WI Certified Fee Database
ClearChoice Data Solutions

Services Overview for Workers’ Compensation Payers 

Click on the images below to learn more about each service.

Medical Bill Review - Rising’s flagship, workers' compensation Medical Bill Review solution is a financially empowering program that allows clients to make well-informed, equitable payment decisions regarding their medical expenses. 
Specialty Bill Review
Specialty Bill Review - The larger the bills, the more we can dig into their intricacies and extract enhanced savings for clients. Compared to traditional repricing methods, Rising produces 37% in additional savings by tapping into the talents of our most highly trained, experienced staff.

Hospital Bill Review - Got big hospital bills? Rising’s Hospital Bill Review leverages all of our Specialty Bill Review capabilities to target any type of hospital bill that you need a closer look at.

Provider Negotiations
Provider Negotiations - Our 360 degree approach to the financial and medical aspects of the healthcare process enables us to negotiate the right price for the appropriate care. At no risk to you, we negotiate on your behalf and agree to equitable terms.
Utilization Management - Our URAC accredited programs review treatment plans to help payers reduce medical costs while providing quality, evidence-based care to patients. They are workers’ compensation Utilization Review services, Peer Review services and Physician File Review services.
Care Management - Rising’s expert medical professionals provide a complete continuum of care management. These services facilitate early intervention, reduce unnecessary future treatment and generate significant cost savings.

Surgical Care Program - Fast. Predictable. Value-Based. We combine these features with top surgeons, all-inclusive case rates, and quality treatment to provide one simple surgical solution. Rising’s Surgical Care Program helps payers and patients receive quicker surgeries and better outcomes at a fair, upfront price.

Physician Pharmacy Review - Avoid unnecessary medical and indemnity expense through early detection of questionable prescription usage behavior. Our workers' compensation drug utilization review  program takes action with Rising’s Rx Intelligence pharmacy analytics and five proven steps, so you get ahead of drug overuse and reduce your claim costs.

MSA Administration - The Medicare Secondary Payer Statute requires workers' compensation payers to “take Medicare’s interests into consideration” when settling claims.  Procuring Administration services for MSA funds shows you are considering Medicare's interests, facilitates post-settlement compliance, and reduces the risk of recovery litigation.
PPO Networks - Rising's Preferred Provider Organizations (PPOs) provide quality medical care to injured employees while also providing a quantifiable form of reduced costs to payers.
Provider Payments - Our Provider Payment solution is an essential component of Rising’s full-service Medical Bill Review program – addressing client operational efficiencies and evolving industry demands.
Payer Web Portal - Simple. Powerful. Proprietary. Our constantly evolving technologies take into consideration one basic element: your needs. Easy to use dashboards, scorecards, charts and grids let you know exactly what you’re accomplishing and what you need to do to stay on top and in compliance. 
Wisconsin Certified Medical Fee Database - "ClearChoice-Wisconsin" is one of the State’s select few certified database services available for repricing workers’ compensation medical charges. By addressing the largest number of medical fee codes in the State, ClearChoice-Wisconsin provides access to the most discounts available.
Rhode Island Workers' Compensation Medical Fee Schedule
 - Rising staff have been authoring, updating and publishing the Rhode Island Workers’ Compensation Medical Fee Schedule since 1996.  Access this page to order or view the Fee Schedule.





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Chicago, Illinois 60654