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Focus Audit

Medical Review Service

Focus Audit
Focus Audit

Medical Review Service

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

Insurance Defense Audits

Medical Review Service

Insurance Defense Audits
Insurance Defense Audits

Medical Review Service

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

Carve Outs/Split Billing

Medical Review Service

Carve Outs/Split Billing
Carve Outs/Split Billing

Medical Review Service

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

Legal Reviews

Medical Review Service

Legal Reviews
Legal Reviews

Medical Review Service

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

Patient Requested Audits

Medical Review Service

Patient Requested Audits
Patient Requested Audits

Medical Review Service

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

Pre-Billing Audits

Medical Review Service

Pre-Billing Audits
Pre-Billing Audits

Medical Review Service

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