National Audit was incorporated in 2001; however the founders of the company have been providing audit services since 1987. National Audit has been acquired by SCIOinspire, Corp., in February 2011.
Staff
National Audit's dedicated
team consists of professional individuals with numerous and varied certifications,
including:
Medical Director (MD) Doctor of Pharmacy (Pharm.D) Registered Nurse (RN) Certified Professional Coder (CPC) Certified Coding Specialist (CCS) Minimum Data Set Coordinator (MDS) (RAC-CT) Registered Health Information Technician (RHIT) Certified Medical Audit Specialists (CMAS) Registered Pharmacists (Rph) Certified Pharmacy Technicians (CphT) Healthcare Risk Manager (HRM) Certified Healthcare Compliance (CHC)
 In addition, clients benefit from the knowledge and expertise of claim
adjusters, a Doctor of Pharmacy and a Physician. The majority of
these individuals have 15+ years experience in
the health care industry.
Background
Since January of 2001, National
Audit has been working with various health insurance providers
performing Hospital Bill and DRG validation audits.
In 2004, it developed a series of specialty audit programs
to meet clients' continuously evolving needs. These programs provide payment validation
reviews in the following areas:
Pharmacy Benefit Management (PBM) High Cost Drug / Home Infusion Durable Medical Equipment (DME) Skilled Nursing Facility (SNF) Contractual terms Validation (Cost + Language) Limitations and Exclusions
These
programs were developed through partnering with clients. National Audit, in conjunction with
individual clients, performed an analysis of provider contracts to determine where there was the potential for
health claim overcharges.
National Audit then customizes audit programs
- called Specialty Audits - to address these potential problem
areas and also assume the risk in conducting the audits to determine if there were, indeed, overcharges to be
found. These Specialty Audit programs have resulted in a significant increase in the recovery efforts for the
clients that have been able to utilize them.
Results
National Audit has consistently doubled growth from year to year with clients utilizing
the above programs, in addition to automating and streamlining processes. In 2005, the
company performed over 5,000 audits which resulted in the identification of over $40 million in overcharges.
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