Service

Charge Capture Compliance Audit Services

A hybrid approach to charge capture audits for hospitals, health systems and practices that want to use both data analytics and clinical professionals to improve reimbursement and mitigate risk.

 

ImproveBilling Accuracy and Reimbursement

  • Leverage our 30+ years of experience helping providers improve efficiency and optimize revenue.
  • Pinpoint under- and over-billing scenarios with thorough claim documentation and process reviews, performed concurrently or retrospectively.
  • Benefit from educating internal teams throughout the organization on charge capture best practices.
  • Identify missed revenue opportunities with a comprehensive review using a hybrid approach of data analytics and clinical staff.
  • Improve processes and mitigate risk of further missed charges with root-cause analyses of revenue variances and performance- improvement plans.
  • Augment staff and access resources to support charge entry/reconciliation processes.

Be Better Equipped to Make Charge Capture Decisions

  • Charge capture assessments and reviews

    • Charge Capture Compliance Audit Services assess the charge capture environment, including processes around the patient clinical encounter, charge creation, and billing processes, to help you improve reimbursement.
    • Our team performs comprehensive billing reviews, charge capture assessments, and charge capture audits for under-billing and over-billing of services. We also manage third-party payer audits.
    • With our process improvement program, we help enhance billing accuracy for sustainable improvements.
  • Analysis and evaluation

    • Our services include an analysis and evaluation of claims for incorrect and/or missing charges.
    • The program identifies potential areas of charge-capture breakdown due to either missed or incorrect charges or codes from the Charge Description Master (CDM).
    • We also review the internal control environment for preventing, detecting, and monitoring missing services, charges, late charges, or other measurements of revenue.
  • Reporting, monitoring, and process improvement

    • Our auditing services include monthly audit details, and quarterly and annual executive summaries with recommendations for charge capture improvements.
    • We provide recommendations to address issues and to improve charge capture and claim- submission accuracy.
    • We assist with standardization and education focused on charge capture process improvement.

Our outcomes

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