The Surgery Sleuth is a new, cutting-edge tool developed by the EML Technology team and funded by the Mutual Benefits Program to revolutionise the way surgery requests and invoices are approved and paid.
This advanced, interactive online tool simplifies the surgery billing approval process, improving both the efficiency of the process and the accuracy of outcomes.
Built with the expertise of our specialists, the Surgery Sleuth cross-references the numerous and complex fees orders to support claims teams in scrutinising the codes and costs associated with surgeries for appropriate approval and payment.
By automating a significant portion of the payment review process, we significantly reduce the time taken for our claims teams to complete this activity, freeing them up to spend more time directly supporting our customers. Meanwhile, the accuracy and efficiency of this bespoke tool serves to reduce unnecessary medical spend on claims.
When incorrect billing practices are identified through the Surgery Sleuth, our teams engage directly with providers, educating them and ultimately working to improve the overall quality of surgery-related requests and invoices before they are even received.
The resulting reduction in medical expenses, and by extension, employer premiums, is part of our commitment to investing in the long-term sustainability of the NSW workers compensation scheme.