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- Evaluate Corporate Compliance Plan
- Evaluate speed and accuracy of payment posting
- Audit end-of-month, end-of-year reports
- Determine potential for electronic claims submission and posting and where current procedures will benefit from updated technology
- Review aging analysis and causes for aging
- Review statement cycle
- Review balancing procedures
- Review current fee schedule and make recommendations for changes
- Analyze third party payments
- Evaluate accuracy of ICD-10 coding of charges and validity of CPT coding
- Review denied claims for trends
- Interview accounts receivable personnel strengths and weaknesses
- Interview accounts receivable personnel for accuracy in the knowledge of coding
- Perform charge audit, comparing hospital logs to charges entered to ensure no missing charges
- Compare payments entered to expected payment profiles
- Compare dates of services to posting dates
- Evaluate refund procedures
- Review quality of demographics and follow-up on bad addresses
- Compare financials with like groups to determine if collections fall in the proper guidelines
- Review all billing data forms and make changes as needed
- Review general office policies and procedures associated with billing system operations for HIPPA guidelines
- Interview physicians to determine needs and concerns as related to the billing area
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