Audacthealth Quality™

Charge Capture Quality Review

Value Proposition:

Audacthealth’s Quality solution ensures consistent, quality, compliant auditing by reviewing accounts that have been audited within a provider’s facility. Audacthealth’s subject matter experts audit these accounts, revealing missed opportunities of charge capture, overcharges that may result in non compliant billing as well as suggestions for charge master enhancement and clinical documentation improvement.

Detailed Solution Overview:

The Audacthealth Charge Capture auditor will re-audit a sampling of the hospital’s completed Charge Capture audits for each auditor currently on the team.

Required documents and utilities:

  • Contract matrix
  • Itemized statements, UB 04s, complete medical records
  • Access and instruction to maneuver through hospital systems
  • Charge Description Master file
  • Charging guidelines, protocols, and policies regarding charging practices for all IP units, Pharmacy, Respiratory therapy, PT,OT, ST, Radiology and key OP areas to include Outpatient Surgery, Endoscopy, ED, OP Chemotherapy/Infusion Clinic, Observation

Once completed a written report of findings and recommendations is produced. The report would include any identified variance along with appropriate citations from charging guidelines or hospital policy. The report would also include selections from previous best practice projects with which improvements to documentation, charge capture processes or bill presentation could yield improved results.

Bottom Line:

Audacthealth recommends an auditor maintain a 95% accuracy rate when auditing. This program indentifies any discrepancies and possible root causes to deviations from this percentage. Confidence in accurate, compliant auditing is a must have for all revenue management.