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Traditional Chargemaster/Billing
Compliance Review
This is a
traditional onsite chargemaster and billing compliance review with a heavy
emphasis on staff education. The review focuses on the Medicare program but
takes into account all of the hospital’s major payers.
Pre Onsite Review
Prior to the onsite, the chargemaster is reviewed for valid CPT/HCPCS codes,
appropriate CPT/HCPCS code and revenue code combinations, and for charges
for non-billable equipment, supplies and services. In addition, a sample of
outpatient claims is reviewed for appropriate documentation, charges,
billings and payments.
Onsite Visit
The onsite portion of the engagement incorporates a general overview of the
various payment mechanisms for the hospital. Areas and issues identified
during the review performed prior to the onsite are addressed and much of
the time is spent on staff education.
While onsite we meet with each of your departments to review areas
including:
Written Report
At the end of the engagement the hospital is provided with a detailed
written report of findings and recommendations. This is a detailed report
with recommendations for each department. It includes an updated copy of the
chargemaster with recommended changes. In addition, related regulations
supporting the recommendations are provided.
Additional Oversight
Assistance with the implementation of the recommendations is available
either as a separate engagement of as part of the initial fee.
Fee Structure
A chargemaster project fee structure varies based on the size and complexity
of your organization. Please call or email us for a Chargemaster / Billing
Compliance proposal.
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