Medical Bill Review Software and Services

Bill Review, Optimized for You

Enlyte's highly configurable bill review platform deploys powerful technology to help claims organizations process medical bills using accurate and up-to-date fee schedules and other benchmarks. Our proprietary platform is pre-integrated with the Enlyte family of solutions including our pharmacy and clinical software, allowing payers to more accurately manage claims and provide full visibility.

Solution Overview

Better Bill Review Outcomes

Enlyte's bill review platform is explicitly designed for the auto casualty and workers' compensation industries. Therefore, it delivers the functionality and features claims organizations need to accurately adjudicate claims, review medical charges and manage regulatory compliance, helping you achieve better bill outcomes.

From intelligent workflows expertly customized to your business to integrated solutions, Enlyte's bill review platform--whether you're using SmartAdvisor or DecisionPoint can help you accurately adjudicate claims, increase operational efficiencies and contain costs.

Features & Benefits

Industry-Leading Bill Review Software & Services

From intelligent workflows expertly customized to your business to integrated solutions, our bill review platform can help you accurately adjudicate claims, increase operational efficiency and contain costs.

Best In Class Technology & Expertise

Contain Costs and Spend More Focused Time on High-Value Tasks

Deep Systems Integration

Accelerate Medical Bill Ingestion & Processing

Timely Fee Schedule Releases

Maintain Regulatory Compliance

Highly Configurable Workflow Rules Engine

Increase Claim Processing Efficiency and Improve Bill Review Accuracy

Automation and Straight-Through Processing

Increase automation through powerful and intelligent business rules and machine learning

Delivery Model

A Delivery Model Tailored to Your Needs

Enlyte offers its medical bill review platform to its clients via one of three methods:

Enlyte Licensed Software

Secure software icon

Business Process Outsourcing

Secure software icon

Hybrid Model

Secure software icon

Business Process Outsourcing

Need More Help? Outsource with the Experts

Our Technology Enabled Services handles your necessary, but often expensive internal operational tasks so you can shift focus to your business’ core competencies. When you outsource with Enlyte, we’ll serve your medical claims with our premier services and bill review expertise, giving you the confidence, satisfaction and trust you need when selecting a bill review services provider. You can be confident your medical claims are being served by the industry’s premier service provider with decades of bill review expertise.

Our team provides comprehensive bill review services, including:

  • Medical bill processing
  • Mailroom operations
  • Document management
  • Data capture
  • Provider contact center
  • Specialized third party liability demand services

Cost Containment Solutions

Enlyte AuditPro

Our AuditPro bill auditing solution employs a unique blend of technology, data and expertise to detect billing errors, and validate and correct medical codes and charges against medical records for bill review pricing. The AuditPro solution addresses a wide range of bill types including professional and facility bills.

Enlyte Specialty Bill Review

Enlyte’s specialty bill review solution provides proven and substantiated usual and customary pricing to help our customers consistently pay out-of-network medical bills when fee schedule pricing is exempt. Our Technology Enabled Specialty Bill Review Solution is supported by a team of experienced Bill Reviewers, Nurses, Legal and Compliance experts.

Enlyte Negotiations Services

Enlyte's direct-to-provider negotiation services helps secure discounted rates on medical bills using a variety of strategies including prompt-pay, data-enhanced and strategic negotiations. Mitchell's Negotiation Services can be utilized across Workers Compensation and Auto claims.


Industry Trends & Insights

Get the latest insights and industry updates you need to know.

Exploring Use of GenAI in P&C

Mainstream use of generative AI has prompted claims leaders to explore how the technology can be used to improve claims management. And while GenAI certainly offers tremendous opportunities for the P&C industry, tech leaders must be diligent in ensuring the intricate knowledge and experience in claims management is integrated into these programs.

Read More

Combat Rising Medical Costs on First Party Auto Claims

Enlyte’s auto bill review solution reduced the medical bill by an average of 80%— so our customer pays 20 cents for every dollar charged. The injured individual gets five times the amount of the medpay/pip benefit. Accurately and efficiently reviewing medical bills minimized litigation and the labor spent reviewing bills.

Read More

How to Use Data to Influence Claim Decisions

Check out the key insights from our exclusive leader to leader webinar with Sentry Insurance experts. Watch the webinar, to discover how data is influencing claim decisions and grab valuable takeaways for your team. What do you need to do to make analytics matter? The key to making analytics matter is to make it actionable.

    Read More
    Learn More

    Improve Bill Review Outcomes