OptiCare's unique physician profiling system helps assure that Plan providers adhere to preferred practice guidelines and current CMS (formerly HCFA) guidelines. Focus is directed to eye care specific utilization and billing patterns to identify and expose fraud, should it exist. Provider specific claims analysis is performed in conjunction with medical record review and providers are then ranked amongst their regional and national peers by sub-specialty. Eye care providers exhibiting under-utilization or over-utilization based on established and accepted norms for their subspecialty are then easily identified. This way we can help guide and educate the provider and ensure the maximum value.
To request more information on OptiCare's proprietary Physician Profiling System contact:
Sales@OptiCare.net.
