Having spent years as a medical director, Merrit Quarum, M.D. witnessed skyrocketing medical costs and disturbing levels of billing fraud and abuse. He formed Qmedtrix in 1996 to find a means to objectively determine reasonable reimbursement for medical services for every area of the health care industry.
To this end, Qmedtrix has built and refined its reimbursement methodology, created an algorithm-based rules engine to identify inappropriate charges, fraudulent and abusive billing patterns, and combined them with a substantial and continuously updated nationwide medical bill database. In California, a state with one of the highest levels of overcharging and abusive medical billing practices, our precedent-setting victory in the case Kunz v. Patterson Floor Coverings (2003) has made Qmedtrix’s methodology the standard in computing accurate and reasonable medical reimbursement.
Today, the Qmedtrix methodology has been successfully used and defended for payment disputes in jurisdictions nationwide. Why does our methodology work? Extensive knowledge of medical procedures and their costs; continuous research of statutes, rules and fee schedules, case law, analysis, contractual language study and comprehensive historical data give us and our clients complete confidence in the validity of our reimbursement recommendations.
The result: accurate, reasonable compensation to health care providers and a major step toward payment reform by correcting inaccurate, abusive and fraudulent billing practices that threaten to cripple our national health care system.
A pioneer in developing innovative solutions and the nation’s health care reimbursement decision expert – we are Qmedtrix, on the road to reforming health care.