The scope of a medical audit is verifying that charges on the detailed itemized hospital bill are accurate and that charges represent services rendered to the patient and are ordered by physician and are based upon standard hospital practices and/or nursing protocols and procedures.
We provide a staff of experienced Nurse Auditors, which includes: Nurse Practitioners, Master Prepared Registered Nurses and Certified Medical Audit Specialist (CMAS) with strong clinical and billing experience.
Our Nurse Auditors will review the complete medical record, which includes doctor’s orders, nurse’s notes and various department reports line-by-line against the itemized bill to ensure that all ancillary services, surgical procedures, supplies, medications, etc. were ordered & delivered to the patient as charged.
AHAP services include not only precise audit details providing audit outcomes but also a detailed monthly audit statistic report to identify departments showing a trend of over charges and under charges including departmental error rates. These audit statistic reports, help to identify the reasons why the over and under charges are occurring and can further assist departments in creating a corrective action plan for resolution to prevent errors from reoccurring. Our role and objective is to form an alliance with your organization in order to assist you achieve your Medical Chart Auditing goals. We tailor a comprehensive audit program designed to meet your individual needs.
“Making a difference where it counts!”
"Documentation errors and omissions can clearly put hospitals and physicians at risk for denials. Most physicians don't understand the link between what they write in a medical record and what the hospital, and they get paid. Nor do they understand the very real risks of fraud and abuse charges that can result from patterns of errors. Understandably, healthcare providers put patient care first and we wouldn't want things any other way. When the doctor is called to see a patient with chest pain, writing a detailed note is just not the first thing on his or her priority list. Too often though, providing excellent patient care is used as an excuse for very poor documentation." Read on