Lost Charge Audits

Today, more than ever, it is crucial for healthcare providers to correctly capture all chargeable items and services in order to maximize revenue, at the same time providing the additional assurances that you are remaining compliant with billing rules and regulations. While every facility works diligently to stay on top of the changing healthcare environment, the reality is, you are still faced with daily challenges and finite staff resources. Praxis Healthcare Solutions will partner with you to help you assess and manage any potential revenue loss. Our experiences have shown there are many inadvertent scenarios that contribute to lost charges.

Examples:

  • New staff not fully orientated on charge capture

  • Incomplete or inadequate documentation allowing the staff member to charge appropriately

  • New services and/or products introduced into the facility yet the CDM was never updated accordingly

  • Potential overcharging, which can lead to compliance and government and payer audits and recoupments

  • Inadvertent billing errors

  • System conversions

Praxis Healthcare Solutions’ clinical team will engage with your team and begin with an initial retrospective audit which will encompass a representative sample of all service areas, with special focus on your feedback to key areas.

Upon completion, a detailed report will be provided showing the specific accounts reviewed, identifying any undercharges or overcharges and broken down by the ancillary services department and the specific cause(s) in order to be used to facilitate internal education and process improvement, thus working towards minimizing future revenue loss. After reviewing the findings with your team, for those accounts identified with undercharges, Praxis Healthcare Solutions will manage the rebilling and follow up on the accounts until successful resolution. After this initial phase, Praxis Healthcare Solutions will provide ongoing quarterly audits in order to monitor improvement and quickly identify any new trends.

Key Benefits

  • Potential found revenue

  • Avoidance of future loss

  • Staff Education

  • Compliments Compliance Program

  • Identification of process breakdowns

  • Minimal time commitment of hospital staff resources