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.

 

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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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