Service

Charge Capture Compliance Audit Services

A hybrid approach to healthcare charge capture audits for hospitals, health systems, and practices that want to improve reimbursement and mitigate risk.

What’s Included in Charge Capture Compliance Audit Services

  • Healthcare charge capture assessments and reviews

    • Assess the charge capture environment
    • Assess charge creation and billing processes
    • Audits for under and overbilling
    • Manage third-party payer audits
    • Focus on sustainable improvement
  • Analysis and evaluation

    • Analyze claims for incorrect/missing charges
    • Identify potential areas of breakdown
    • Codes from Charge Description Master (CDM)
    • Review internal control environment
    • Help monitor and detect missing revenue
  • Reporting, monitoring, and process improvement

    • Monthly audit details
    • Quarterly and annual executive summaries
    • Charge capture improvement recommendations
    • Help address issues affecting claim accuracy
    • Assist with standardization and education

Services to supportbilling accuracy and reimbursement

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Expertise to help improve the revenue process

Leverage our 30+ years of expertise helping providers optimize revenue. Our experts and resources can help you detect and correct missed revenue opportunities in your charge entry and reconciliation processes. We also help educate your organization on charge capture best practices and use a process improvement program to facilitate sustained gains.

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Assessments to help improve healthcare charge capture

Focused on helping to support reimbursement, our experts will assess your charge capture environment, reviewing processes around the patient clinical encounter, charge creation, and billing. We perform healthcare charge capture assessments and charge capture audits for under and overbilling of services, plus manage your third-party payer audits.

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Combining data and analyses to get the full picture

Our approach combines analytics and clinical staff to help ensure a comprehensive review. We perform root-cause analyses of revenue variances and provide performance improvement plans to help prevent further missed charges. We alert you about areas of potential breakdown and provide recommendations for supporting your claim submission accuracy.

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