Revenue Cycle Billing and Compliance Assessment

Revenue Cycle Solutions designed to improve reimbursement challenges

How does your facility’s level of compliance rate with the following risk areas?

  • Compliance with the Office of Inspector General’s (OIG) Work Plan
  • Accurate charge capture
  • Proper orders and physician authorization
  • Evaluation of non-covered charges that are bundled and billed as covered charges
  • Compliance with national coverage and local medical review policies
  • Medical Necessity and Advanced Beneficiary Notice of Noncoverage (ABN) notification
  • Observation admission criteria
  • Drug administration charging
  • Accurate Healthcare Common Procedure Coding System (HCPCS)/CPT code assignment from the Charge Description Master (CDM) and Health Information Management (HIM)
  • Upcoding/Unbundling
  • Appropriate modifier -59 assignment
  • Correct revenue code assignment
  • Level of service issues for E/M facility visit charges
  • Correct UB-04 claim form population
  • Correct posting and coinsurance follow-up per AR account history
  • Number of times that claims are resubmitted to Medicare due to errors/edits
  • Correct Coding Initiative (CCI) and Outpatient Code Editor (OCE) Compliance

Are you faced with any of these issues? If so, turn to AMS Consulting Services for a Revenue Cycle Billing Compliance Assessment. This comprehensive assessment is designed to identify specific areas of compliance-related issues in the revenue cycle as well as issues that have a negative impact on reimbursement. Both inpatient and outpatient areas are reviewed by AMS consultants using our comprehensive review process, which is designed to reveal compliance related issues from patient scheduling through payment posting.

For further information regarding the Revenue Cycle Billing and Compliance Assessment, please Contact Us