Lost Charge Audits & Charge Capture Audits

Today all healthcare providers are losing revenue they are entitled to receive. Why is this occurring? Simply put the staff in every institution does not charge appropriately or not at all for all the services they document as providing for which they would receive revenue. MedCompliance staff works hand in hand with each client to identify lost revenue opportunities and implement process improvement throughout the revenue cycle plus training and documentation programs to reduce lost revenue.

Our Lost Charge Audit goal is:

Identify lost revenue situations and correct the process by training the staff through process improvement.

Our Lost Charge Audit project will accomplish the following objectives:

1. Obtain for audit 50 outpatient charts with detailed bill and UB for each of these financial classes:

• Medicare
• Medicaid or MediCal
• Commercial Carrier such as Blue Cross

2. Obtain for audit 50 inpatient charts with detailed bill and UB for each of these financial classes:

• Medicare
• Medicaid or MediCal
• Commercial Carrier such as Blue Cross

3. Audit every chart for documentation and charging accuracy and in the following areas:

• Physicians order(s)
• Physician documentation of service(s) provided
• Nurse and technician documentation of service(s) provided
• Insure orders match services, if issue exist then document findings
• Validate every service, supply and device provided to a charge on the detailed bill
• Insure every service, supply and device match their respective charge, if issue exist then document findings and revenue impact (positive and negative)

4. Prepare report by department where documentation and revenue issues occurred. Plus an impact report by department of lost revenue.

5. Meet with each identified department director to review report of findings and prepare recommendations to prevent further occurrence.

6. Design and provide educational materials to assist in documentation and charging to reduce lost charges.

7. Provide departmental educational sessions as needed to enforce importance of documentation and charging accurately.

8. Deliver report to administration of audit findings and each department's methodology for rectifying issues in the future.

9. Assist in developing a daily charge reconciliation policy and procedure if one is not in existence.

10. Review with every department director the importance of daily charge reconciliation

11. Repeat audit sampling again by financial class and patient type every month until results reflect no issues now exist in documentation and charging. Prepare reports of findings.

All employees of MedCompliance Services, Inc. under the direct supervision of Jessy Huebner, MAT, CHFP

Number of years offering Lost Charge Audits and related education:

• Thirty years

Education/Training Experience:

• Mr. Huebner holds a Master's Degree in Teaching and has personally performed hundreds of OR/Surgery Case Leveling Programs. Continually staying in the trenches helping and teaching Healthcare staff members how to maintain compliance in documentation, charging and coding correctly. Fifty percent of his time is spent teaching reimbursement education with over 5,000 hours logged at the podium.

MedCompliance Services hours of operation are: Monday - Friday 8AM to 8PM EST to answer any related question the client may have.

• MedCompliance Services provides a written report at the end of each engagement.
• We track performance by auditing a sample of patient charts on a monthly basis to insure data integrity and compliance.
• We have a high customer satisfaction by responding to each and every question and/or request in a timely manner not to exceed 24 hours.

By performing the Lost Charge Audit project it will result in increased revenue and documentation improvement. It is a well-known fact that that third party audits will decrease as a result of clean data and clean claims.

It is strongly recommended establishing proper oversight and control and to maintain a high level of employee understanding of this program.

If you have questions, please contact:

MedCompliance Services, Inc.
Jessy Huebner, MAT, CHFP, CEO
800 West Avenue #1001
Miami Beach, Florida 33139