claims review

Advent Case Management, LLC is a California-based, women-owned organization certified by WBENC and WOSB. Its team of experienced healthcare professionals provides comprehensive medical case management services, working with insurance carriers, employers, TPAs, and injured employees to coordinate care, support recovery, and promote positive outcomes while minimizing overall claim costs.

bilingual case managementbill review/negotiationcost containment analysisMedical Case Managementnurse case managementNurse Triagereturn-to-work program

Bursal Consulting & Management is a construction management consulting firm led by President Zeynep Bursal, who has 30+ years of experience in construction management. The firm offers project management, cost estimating, scheduling, and risk assessment services, and is DBE and WBE certified. Zeynep Bursal holds an M.S. in Construction Management and a B.S. in Civil Engineering from USC.

Cost Estimatingdesign reviewproject managementQA/QC reviewsRFI and submittal managementrisk assessmentscheduling

Downtime Subrogation, Inc. specializes in recovering loss of use damages for commercial fleets whose vehicles are out of service after non-preventable accidents. It provides deep claims reviews of closed accident claims, end-to-end subrogation support, and claims audits, working on a commission-only basis with no upfront costs.

claims auditsloss of use recoverynegotiation and recoverysubrogation

Highlight Health is an independent reviewer of large healthcare claims for self-funded health plans and the people who fund them. It performs pre-payment review of high-dollar medical claims, producing a Documented Record of what the price should be and why. The work draws on claims specialists, certified coders, clinicians, actuaries, and attorneys. Founded 2020 and based in Philadelphia, it takes no fees from the providers, networks, PBMs, or carriers it reviews.

actuarial analysiscoding verificationlegal reviewpre-payment claim reviewpricing verification

Kelly Willenberg, LLC is a full service compliance company specializing in research healthcare compliance. Led by Dr. Kelly Willenberg, the team provides clients with over 250 years of healthcare experience and 100 years in clinical research, with hands-on clinical experience in clinical trials, billing, regulatory, and research compliance. The company is certified as a Women's Business Enterprise by the Women's Business Enterprise National Council (WBENC).

budget and contract negotiationsbusiness planscharge segregationclinical trial billing auditscoverage analysisgood clinical practice auditson-site evaluation and auditprocess improvementregulatory assessmenttraining