Forensic Billing
Hospitals often experience a high number of claims that are held up by the bill scrubber due to National Correct Coding Initiative (NCCI) edits, other modifier needs, medical necessity code requirements, duplicate charges, missing procedures, missing dates/times, medically unlikely edits, etc. that are difficult and expensive to identify, and often result in denied charges.
Med-Scribe Clients can successfully address these issues, resulting in millions of dollars for the facility that was once written off. With an industry approved HIPPA compliant VPN connection to the client's system, the bill and associated medical record documentation are researched before corrections are made. This additional labor solution resolves the error identified by the scrubber and reclaims lost revenue.
- Change your approach by moving your case reviews to the front end of the revenue cycle with "pre-bill" review services to ensure accuracy of your initial claims.
Our Forensic Billing suite accurately and affordably corrects demographic, insurance, coding, and billing information before claims are submitted, thus increasing the chance of submitting a clean claim, reducing the number of denials, and mitigating resource-intensive appeals. - Refocus your expensive onsite coding staff to high yield claims while allowing our remote clinical coding experts to focus on the low-yield, high-volume accounts.
Our Forensic Billing staff specializes in recovering claims and/or overturning denials, oftentimes on accounts with dollar figures that previously may have been written off due to time and resource constraints. Not only will this have a positive impact on your bottom line, but it will also limit coding staff burnout and reduce inefficiencies. - Identify trends and their root causes, and leverage actionable data to assist with making long-term change for future provider viability.
What good is all of this if it doesn't positively affect future behavior and bottom-line revenue? Our resources will also provide you with the necessary data your health system can use to measure revenue cycle performance, track denial codes, and other key performance indicators.
