Bill review / The core service
Every line has to earn its place.
Scout examines professional, facility, pharmacy, and complex bills against the standards that govern the charge—and returns the reasoning with the result.
Our entire product focus
Independent medical bill review.
No case management. No utilization-review product line. No managed-care bundle.
The standards we review against.
- 01
State fee schedules
Jurisdictional pricing applied at the version in force on the date of service.
- 02
Medicare and UCR benchmarks
Applied where no jurisdictional schedule governs the charge.
- 03
Federal schedules
Including OWCP schedules where the program applies.
- 04
Coding accuracy
CPT, ICD, DRG, units, bundling, and modifiers.
- 05
Duplicates
Duplicate and near-duplicate charges across bills and providers.
- 06
Medical-necessity flags
Raised for payer follow-up. Scout does not sell utilization review.
- 07
Preferred-network rates
And other applicable arrangements, tested for eligibility and advantage.
- 08
Client-specific rules
Authority, thresholds, and escalation instructions you define.
Bill types
Four classes of bill. One method.
01Professional
02Facility and hospital
03Pharmacy
04Complex and high-dollar
Line-item EOR / EOB
Submitted and recommended amounts
Adjustment reason by line
Rule or citation for each reduction
Time-stamped audit trail
Report-ready savings classification