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Some of
the billing errors that have been found are:
-
Room charge – hospital incorrectly billed for an ICU
room when patient was in a semi-private room.
Overcharge resulted in the insurance company
overpaying more than they should have.
-
Male patient in mid-fifties goes into hospital for a
hip replacement and finds charges on his bill for
nursery and newborn tests.
-
$90
charge for IV usage that cost the hospital 70 cents
-
Charges for items that are generally considered a
courtesy item. For example, $12 for mucous recovery
system or a little box of tissues.
-
Charges for ordinary supply items that are
considered to be a part of the room cost, towels,
sheets, gowns.
-
Charges for operating room equipment that is
included in the cost of the operation.
Saving
money for your clients is our goal. Our team members
have the skills and knowledge necessary to review all
aspects of a medical case, whether it be medical bills,
billing or insurance (EOB) statements. We do a line by
line analysis of every item listed and watch for any
items that are not in compliance with federal and state
billing guidelines, Local Medical Review Policies (LMRP)
and the correct coding initiatives (CCI).
All
team members are trained and have the knowledge and
experience to recognize many of these errors/overcharges
quickly.
Our
bill review is not limited to just hospitals. We can
review any type of claim regardless of where the service
is provided. Claims that we can review include:
worker’s compensations, motor vehicle accidents (MVA),
medical malpractice, and estate medical bills.
Upon
completion of our review, you will be provided with a
detailed report showing our findings. These findings
will be backed up with the reference source showing why
we have slated that charge for denial. We do a
comparative analysis as to what Medicare would pay for
the same services
Compliance verification with federal, state regulations
and guidelines, LMRPs, and CCI edits.
In
conclusion, Medical Bill Consultants, LLC will work with
you on you and your representative to prepare a report
that will be usable in court to defend these denials.
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