What we look at
- Payments against your contracted rates, by payer
- Denials by reason, payer and age
- Days to payment and the age of unpaid claims
- Time, physical status and modifier patterns across a sample of cases
- Claims that were never resubmitted or appealed
What you get back
A short written summary in plain English: what's working, where money is slipping, and roughly how much. You keep it whether or not you work with us.
What we need from you
A payment report, a denial report and an aging report for the last 12 months. Your current biller or billing system can usually export these. We sign a business associate agreement before we see any patient information.
Is this the same as a compliance audit?
No. This review is about money and process. If you're facing a payer or government audit, read preparing for anesthesia billing audits and talk to a healthcare lawyer.
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