• Designed specifically to meet the needs of your facility
• Helps improve revenue integrity by focusing on charging and documentation processes
       - Ensure you aren’t missing revenue
       - Make sure you are following applicable billing rules to maintain compliance
• Creates a dialogue between clinicians, finance, and compliance

Usually... View full description

• Specifically targeted to one department or service area within your facility
• Great for new service lines or system implementations
• In conjunction with the chart audit program
• When a problem area is identified, take a closer look to find a solution

Ever have a new system implemented, and suddenly, your charge revenue drops?  Institute a new service line and don’t realize the additional revenue?  Most... View full description

• Tired of insurance auditors taking your money back?  Make sure you have someone on your side.
• MRS has the experience to keep as much of your money as possible. We will preaudit the account to make sure the insurance auditors are held accountable for their results.  We will add items where documentation supports and defend your charges that the insurance auditor is attempting to remove.

Medical Review Service has a long history of defending facilities.  Insurance... View full description

• Everyone has to deal with splitting charges on certain types of accounts.  But how do you decide what gets billed to which payer?  We’re here to help.
• Hospital Acquired Conditions
• Organ Procurement
• Multiple Payers
• Legal/Risk Related Accounts

Many payers require accounts to be billed differently when certain things occur.  Whether there is an adverse event, a patient on... View full description

• Assure the accuracy of charges involved in a legal case
• Testify to the accuracy of a claim

Cases that end up in a legal setting are unsettling to say the least.  Remove a portion of the worry by having one of our nurse auditors review the case for documentation and accuracy of charging. As an impartial third party, our reviews and/or testimony to the accuracy of the charges and documentation carries more weight than that of an internal auditor employed by the... View full description

• Independent review of charges by nurses who are not affiliated with the provider

We all know that patients have questions about their bills.  When handled inappropriately, these can blow up into news stories.  Patients generally want to know that they were billed appropriately and to understand what they were billed for.  Our nurse auditors can help by reviewing the accounts to make sure things are correct and advise customer service personnel so they can explain the results to a patient or even... View full description

• Make sure all charges are correct before the bill goes out the door
• Especially important on accounts that are close to the stoploss amount

Most accounts are paid by DRG these days, but many contracts still have stop-loss dollar amounts where cases change to a percent of charge payment.  How frustrating is it when an insurance company later reviews that case, and the amount drops below the stoploss amount and ends up throwing off your budgeted amount?  An audit of these... View full description

• Random sampling to ensure the accuracy of your coding
• Defend against payers who attempt to downgrade the coding

Proper coding is the key to maximum reimbursement. Our audit staff can review your codes through a random sample to make sure your facility is receiving the maximum reimbursement. In addition, we have experience with payers who attempt to lower your coding to reduce their... View full description

• Work edits for your team to ensure proper billing
• Work with hospital personnel to drive down future edits

Is edit resolution taking all of your business office time? Coders sick of spending all their time resolving the issues? Seeing the same edits over and over?  Medical Review Service can help with all three. We take the time to understand why the edit is occurring, identify the root cause of the problem, and work to resolve that issue. Our goal is to lower the number of... View full description

• Certain areas of a facility have difficulty capturing all of their charges
• Take charging out of the hands of your clinical staff
• Get it right the first time

So many areas of a facility still have to charge manually.  How good is the clinical staff at capturing the correct charges for complicated procedures?  Medical Review Service has a team of experts ready to help. 

Areas of particular difficulty... View full description