Independent Healthcare Consultants LLP

APC Payment/Coding

Many facilities do not realize that they are not receiving appropriate payments under APCs. The APC Payment/Coding Review is an in depth review of the hospital’s current documentation, coding and billing processes in relation to Medicare’s APC payment methodology. Typically, 30 paid outpatient Medicare charts are reviewed. The review looks at:

• Are all the services documented in the chart actually billed
• Do all the charges on the itemized statement have supporting documentation in the chart
• Are all of the charges appropriately reflected on the UB-04 claim form
• Are the Medicare payments appropriate, given the claim that was submitted

This service includes an onsite component to discuss, with the staff, those areas where improvements could be made in the documentation, coding and billing processes.

Please call or e-mail for the fees for our APC Payment/Coding reviews or to further discuss this service.

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                 Independent  Healthcare  Consultants  LLP

PO  Box 7417

Bismarck, ND  58507-7417

Phone & Fax: (701) 223-8473