• 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-9 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