Home / Two-Tier Process
The DemandPro Approach

A Comprehensive Two-Tier Review

All reviews conducted by certified coders and nurses — ensuring consistent, defensible, court-ready analysis, claim after claim.

I
Tier I

Medical Bill Audit

Certified coders review every bill against jurisdiction-specific fee schedules, flagging improper coding, unbundling, and excessive charges across all bill types.

  • Inpatient & outpatient billing review
  • Diagnostic & prescription audit
  • NCCI coding edits applied
  • Unbundling & excessive charge identification
II
Tier II

Expert Nurse Clinical Review

Certified nurses analyze causality, identify unrelated treatments, assess medical necessity, and deliver clear, actionable negotiation recommendations.

  • Causality & relatedness analysis
  • Unrelated treatment identification
  • Medical necessity assessment
  • Defensible clinical documentation
The Seamless Automated Workflow

100% RMIS Integration

Syncs directly with your existing claims management system.

Proprietary Package Assembly

Medical records organized chronologically into adjuster-ready packages.

Complete Audit Trail

Full visibility with time-stamped documentation for every review step.

Go Deeper on Tier II: Nurse Clinical Review

Let's Talk

Walk Through the Process Live

See DemandPro in action. We'll walk you through the two-tier review process, answer your questions, and explore how it fits your claims workflow — no commitment required.

  • Walk through the full two-tier review process
  • See a sample deliverable package
  • Get your questions answered — no pressure
Schedule a Call →

30 minutes · No commitment · Pick a time that works for you