Q-Work is the by-product of a partnership between Health Net Plus, the workers’ compensation managed care services unit of Health Net Employer Services, Inc, and Qmedtrix Systems, Inc. The product will assist employers in electronically reviewing bills for accuracy and fairness.
In instances where a contract or a fee schedule does not exist, the Q-Worx “rules” engine is applied. The number of rules applied, or the modules utilized, can be customized for each client. Modules can be applied for results that include:
- Hospital outpatient facility charge review
- Ambulatory surgery center (ASC) facility charge review
- Surgery charge review
- Pain management charge review
- Inpatient DRG check
- Self-referral screening.
Q-Worx software is installed and claims data transmits electronically through the Health Net Plus electronic interface application. Health Net Plus contracted provider and facility reductions are applied to medical bills with results available to the customer.