Regulatory Compliance Analysis

 

 

 

 

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Healthcare Consulting Services, LLC (HCS), is experienced in providing hospitals with outpatient billing compliance analyses. Our professionals will assess your facility’s coding, documentation and billing practices to help identify specific areas of Medicare non-compliance.

At HCS, we have found that hospitals performing periodic billing compliance analyses reduce the risk of:

Investigation by "Focused Medical Review"

Submission of False Claims

Billing upcoded, fragmented or inappropriately bundled services

Increased Medicare claim denials

We understand the coding and billing issues being attested and will work to ensure the hospital is billing in compliance with Medicare guidelines. Our professionals will examine a representative sample of claims to identify specific areas of Medicare non-compliance. We will help the hospital identify non-compliance issues and trends while providing specific recommendations to improve the hospital’s billing policies and procedures. Upon the completion of our analysis, we will provide the hospital with a detailed report that identifies, by claim, all potential compliance issues noted during our analysis.

Often a billing compliance analysis may impact other billing and coding issues such as:

Chargemaster Analysis

Inpatient Coding

Ambulatory Surgery Coding (ASC)

DRG Assignment

Medicare and Medicaid Cost Report

Hospital Re-Engineering

If your Hospital needs assistance in any of these areas, HCS can help. We have a full range of services available to hospitals and other healthcare providers. If you are interested in scheduling an Outpatient Chargemaster Review or are interested in learning more about it, please call Jeff Neff at (317) 633-4708, Ext. 323 or e-mail at jneff@hcs-healthcare.com.

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