The Argus West SIU Lien Unit (SPEAR Program) flagged a specific medical group provider for several objectional reasons on the front-end through our client’s bill review platform.  During the lien handling, our claims expert reviewed the claim for any claim-based defenses. Upon full review, the SIU Lien Unit found that: 

• The provider had not adhered to the DWC Billing Guidelines on several important requirements.
• The provider inflated billings using unjustified CPT codes. 
• Although the provider continued to treat after the claim was resolved, the last date of service prior to that resolution put their lien outside the statute of limitations. 
• The provider had been unresponsive to previous demands for financial interest disclosure. 

Our lien negotiator sent a letter to the lien claimant, informing them of our findings and our position on the issues. On the date of the Lien Conference, the lien claimant did not show up. The Argus West SIU Lien Unit requested the Judge submit a Notice of Intent to Dismiss Liens. 10 days later, the Judge granted the lien dismissal, securing significant savings for our client.

Argus West’s SPEAR Program is a front-end and back-end provider fraud and abuse solution.  Our proprietary software is a one-of-a-kind and industry first SIU perspective layer integrated into any existing bill review platform.   SPEAR provides SIU based reason codes and objection language for flagged providers.  No more money going out the front door!  The back-end SPEAR program is our lien unit.  In the SPEAR Lien Unit are highly qualified, former claims adjusters and lien hearing representatives holding flagged providers accountable.   With over a 99% savings track record to attest to, SPEAR gives you an additional 35%+ savings over traditional internal claims team lien handling, third party lien companies and/or defense attorney negotiated liens.  In addition, our clients are saving 4 times the cost of hiring a third-party lien company or defense attorney to negotiate your liens.  Want to take the burden off your adjuster, save big $$$ in your medical expense bucket and lower lien negotiating costs, SPEAR is your program with proven success. For more information contact by email:  spear@arguswest.com