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Payment Validation Case Studies Information
 
APC Validation
Cosmetic Reviews
DRG Validation
Surable Medical Equipment
Hospial Bill / Medical Charts
Implantable Devices
Itemized Bill Review
Non-facility High Cost Drug, Home Infusion and Specialty Pharmaceuticals
Facility-based High Cost Drug
Skilled Nursing Facility

 

 

Audit Services

"On an annual basis, our overcharges identified from hospital bill audits have increased 3 – 4 times that of previous years since contracting with National Audit.”
Harold Davis
Director of Financial Recovery
Humana

Audit programs are specially designed to closely scrutinize and assist in the controlling the costs associated with incorrectly billed and overpaid health claims. Through our vast experience in this area, National Audit continuously maintains, updates and enhances a national database and target list of susceptible codes and/or services.

We have designed the delivery and focus of our services and technology to optimize the results received by our clients, particularly by:

  • Developing industry - leading best practices
  • Increasing claims processing and payment accuracy
  • Ensuring provider and facility billing accuracy
  • Increasing medical claims budget through accurate allocation of existing medical loss ratio dollars
  • Enhancing and protecting provider partnerships and relationships
  • Maintaining flexibility with our own work flows in order to integrate seamlessly into our clients' existing process

Our programs are designed to start where your technology-driven health claims editing programs end.

How are you measuring your current auditing program’s performance?

Do you know what these industry best practice standards are within your own organization?

What is the acceptable and optimal percentage of claims selected for audit, by type?
What acceptable and optimal percentage of savings identified for each audit type?
What is an acceptable audit turn around time, by type?
What quality assurance programs are in place to ensure optimal performance?

Allow us to help you ensure you are receiving the best results possible!

 

   

NATIONAL AUDIT
Providing health care claims payment validation services since 1987.

National Audit, a Florida-Certified Minority Business Enterprise (MBE), provides the most complete array of health claim audit programs in the industry, including
APC validation, hospital bill/medical charts, cosmetic reviews itemized bill, DRG validation implantable devices, durable medical equipment pharmacy benefit management (PBM), non-facility-based high cost drug, home infusion and specialty pharmaceuticals, facility-based high cost drug, and skilled nursing facility services.

Jacksonville • Coral Gables • Tampa • Louisville • Lancaster • Raleigh

866-628-3488


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