Company
Contact Name
Phone
Email


Upload File(s)
or Complete a Form

Type of Claim:
Provider:
Provider Tax ID:
Total Billed Amount:
Dates of Service:
Diagnoses Codes:
Procedure Codes:
DRG code:


Revenue
Code		 CPT/HCPCS
Code		 Modifier Units Billed
Amount
       

Notes
"We resolve to be forerunners of an international paradigm shift to reduce medical costs through the innovative, technological application of public and proprietary data sources to objectively define fair and equitable payments for medical services."

 

Medical Cost Remedy, Inc.
15944 Midway Road
Addison, TX 75001
888.318.4600