Billing > Billing

Hospital Auditing... Auditing in General

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QueenAlicia:
In regards to auditing can anyone share information on what the process is. 

How do you complete a chargemaster review? 

Michele:
Not sure what you mean by "Chargemaster review".  Do you mean the fees that the provider is charging.  For me I don't have one process I follow for auditing.  It depends on the situation, what the problems are, and what I'm (the provider) is looking for.  It also depends on a lot of things like what PM system they use?  Do they do the billing in house?  How much time do I have in the office?  Am I doing a full audit, or just one particular insurance carrier?  Who is doing the billing?  Lots of variables.  Sorry, I don't feel like I helped much.  :(

QueenAlicia:
It was for a hospital and I assume that they wanted a review of all the lab claims to review.  They also wanted an inhouse interview of their staff on their billing procedures.

It was a lot of unanswered issues in the proposal.  They weren't to clear as to what they exactly wanted.

Michele:
I would make sure they are specific in what they want.  You can't do a good job if you don't know what they are looking for.  The inhouse interview shouldn't be a problem but you need to know what they expect you to accomplish.

QueenAlicia:
Yes, I turned it down because I do not know all of the qualifications and don't want to bid and take a job that could possibly ruin my business reputation.

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