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Green Light's Medicare-Like Repricing solution allows your organization to maximize the opportunity to save with allowable determinations based on Medicare fee schedules.  Our fully customizable technology gives our clients the ability to retain complete control over how the program operates through dynamic rule sets.  

 

Configuration options include rules-based claim handling by:

 

Provider Type

  • Primary Care Physician / Specialist

  • Hospital / Specialty Hospital

  • Ambulatory Surgical Centers

  • Ancillary Providers

  • ESRD - Dialysis

  • Durable Medical Equipment Providers

 

Provider Specialty

  • Based upon Taxonomy code

 

Service

  • Inpatient Hospital

  • Outpatient Hospital

  • Specific DRG

  • Specific Principal, Admitting, Procedure Diagnostic (ICD-10) Code(s)

  • Evaluation & Management Codes

  • Radiology Codes

  • Pathology Codes

  • Surgery Codes

 

Geographical location of either the insured or the provider

 

All options are configurable down to the group/employer level.

Medicare-Like Repricing