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Bill
Audits
Medical Management Services
manages and services our Bill
Audit product. Our Bill Audit
is a cost savings tool which
acts as an auditing system as
well as a control mechanism for
the payment of medical billing.
It is often used in conjunction
with a peer review to optimize
the analysis of a case.
Our Bill Audit service compares
pricing on CPT codes issued by
the American Medical Association
(AMA) to our database which
contains a “usual and customary
rates” (UCR) for each CPT code
by geographical area. Our
database utilizes the most
current national pricing data
combined with our internal
Network physician’s model.
These data sources combine to
form a creditable re-pricing
model for comparison purposes.
In addition, our audits detect
duplicate billing for CPT codes
for the same patient on the same
date of service and identifies
them with the original billing
audit number. Our audits are
easy to understand and only show
the actual savings from the
codes that were reviewed.
However there are much more
savings achieved through the
identification of incorrect
codes and the control against
duplication of payment.
In addition we make the data
from your audits readily
available to you. This unique
feature is a helpful tool when
discussing the reasonableness of
fees with an individual
provider. You will have the
actual name of facilities and
the fees that you were charged
you at your fingertips.
Our product stands apart because
of the ability to customize our
programs to meet our customers
needs, our guaranteed turnaround
time on the completion of the
audits and the valuable data
that is available in our monthly
reporting. An account
representative is available to
assist and coordinate the
in-house processing of all Bill
Audits. |