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Medical Chart Auditing/Hospital Bill Audits

The financial success of any healthcare organization is dependent upon accurately charging clients for the services they have received. Reimbursement based on charges remains an important component of any healthcare organization.

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.

Nurse Auditing Service

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.

Monthly Audit Statistic Report

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!”

Auditor's Corner

"The recent announcement by CMS regarding its modification of additional documentation requests for institutional providers during fiscal year 2010 has generated considerable response from providers seeking clarification about tax identification numbers and definitions of terms like "campus." Each RAC annually is expected to establish a per-campus cap on the maximum number of medical records it can request per 45-day period. " Read on

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