MedWatch Achieves Unprecedented Savings with High Dollar Claims Review Services
Lake Mary, Florida, March 25, 2025 — MedWatch, a trusted leader in population health and medical management, is proud to announce the exceptional results of its high-dollar claims review services, which include dialysis, medical transport, high-cost pharmaceuticals, out-of-network repricing, and more. The company’s RN clinical review team recently delivered impressive savings by reviewing a dialysis claim that initially totaled $281,661.32. After billing appropriateness was assessed and the claim was repriced at 140% of Medicare, MedWatch saved the client 95.2%, reducing the amount owed from $281,661.32 to just $13,646.40, resulting in savings of $268,014.92.
The claim involved a member who was receiving daily, at-home peritoneal dialysis treatments. The MedWatch RN clinical review team identified that $118,667.72 of the billed charges were considered inclusive to the dialysis and, therefore, ineligible for reimbursement. The claim was then repriced at 140% of Medicare, ensuring the client received a fair and transparent price for these critical treatments.
This case is just one example of how MedWatch’s high dollar claims review services provide healthcare savings without sacrificing quality or care. Since MedWatch began reviewing dialysis claims in 2012, they have never lost an appeal. The company also prides itself on offering clients a flat fee structure for these services, rather than charging a percentage of savings. In this instance, had the client used their previous vendor—who charged 20% of savings—the fee would have been $26,801.49, leaving the client with significantly higher costs. With MedWatch’s flat-fee approach, the client received substantial savings without any surprise fees or hidden charges.
“Our high dollar claims review services offer unparalleled value to our clients,” said Sally-Ann Polson, CEO of MedWatch. “By applying our expertise and clinical knowledge to high-cost claims, we not only ensure accuracy but also deliver real savings to clients and members. This example of a dialysis claim is a perfect illustration of how we provide both cost containment and peace of mind to our clients.”
MedWatch continues to lead the industry in providing tailored solutions that enhance both financial and health outcomes. With over 36 years of experience and a wide range of population health services, MedWatch remains committed to supporting its clients with effective, cost-efficient strategies that prioritize the health and well-being of their members.
About MedWatch: MedWatch is a trusted leader in population health and medical management with over 36 years of experience and more than 30 tailored solutions focused on improving both health and financial outcomes. Our exceptional white-glove concierge advocacy services ensure that every member feels valued and supported throughout their healthcare journey. MedWatch’s URAC accreditation in Health Utilization Management, Case Management, and Disease Management, along with our completion of the SOC 2 Type 1 audit, highlights our unwavering dedication to excellence and our steadfast commitment to protecting clients, members, and their data. To learn more, visit urmedwatch.com.
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