"On
an annual basis, our overcharges identified from
hospital bill audits have increased 3 – 4
times that of previous years since contracting
with National Audit.”
Harold Davis
Director of Financial Recovery
Humana
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Audit programs are specially designed to closely scrutinize and assist in controlling
costs associated with incorrectly billed and overpaid health claims. Through our vast experience in this area,
National Audit continuously maintains, updates and enhances a national database and target list of susceptible
codes and/or services.
We have designed the delivery and focus of our services and technology to optimize the results received by our
clients, particularly by:
- Developing industry - leading best practices
- Increasing claims processing and payment accuracy
- Ensuring provider and facility billing accuracy
- Increasing medical claims budget through accurate allocation
of existing medical loss ratio dollars
- Enhancing and protecting provider partnerships and relationships
- Maintaining flexibility with our own work flows in order to integrate seamlessly into
our clients' existing process
Our programs are designed to start where
your technology-driven health claims editing programs end.
How are you measuring your current auditing program’s
performance?
Do you know what these industry best practice standards
are within your own organization?
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What
is the acceptable
and optimal percentage of claims selected for audit,
by type? |
| •
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What acceptable
and optimal percentage of savings identified for each audit type? |
| •
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What is an
acceptable audit turn around time, by type? |
| •
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What quality assurance programs
are in place to ensure optimal performance? |
Allow us to help you ensure you are receiving the best results possible!
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