Hospital Billing and Payment can provide the following services to PPS and CAH hospitals (including SNF, swingbed, and hospital based RHC):
• Understanding UB04 billing
• Understanding the Fiscal Intermediary Shared System
• Medicare Part A for beginners
• Revenue Code/Charge master workshop (Facility or Group)
• On site and Off site review of Remittance advices
This identifies billing and reimbursement problems. It can also identify charge problems. We can
• Understanding the Fiscal Intermediary Shared System
• Medicare Part A for beginners
• Revenue Code/Charge master workshop (Facility or Group)
• On site and Off site review of Remittance advices
This identifies billing and reimbursement problems. It can also identify charge problems. We can
teach your staff to do this or we will provide this service. A regular review of RA’s can quickly
identify problems with charge, billing and reimbursement.
• On site review of Medicare files, RTP, denials etc.
• On site claims audits for billing accuracy and payment
This is our most requested service. The process involves a thorough review of claims, records,
• On site review of Medicare files, RTP, denials etc.
• On site claims audits for billing accuracy and payment
This is our most requested service. The process involves a thorough review of claims, records,
itemized statements and payments. The review consists of a selection of accounts by first
reviewing RA’s. Next, an onsite audit of documents previously described is conducted. During this
process we will provide a written document of findings and meet with key staff to discuss and
provide education.
• IV Infusion Education and Other department Education
• IV Infusion Education and Other department Education
• On site billing education
Working with billers to understand edits, billing resources, follow upCHARGEMASTER REVIEW
CDM review objectives:
• Review for correct CPT/HCPCS coding
• Review for correct UB-04 Revenue Codes
• Review CDM for Modifier’s
• Review CDM for Description Issues and Missed Reimbursement opportunities
Admit Inpatient vs. Outpatient reviews and education
Work with Department Managers and CDM Coordinator to validate the accuracy of services charged.
A well-managed charge description master is the first line of defense against denied claims.
These services have a significant impact on reimbursement.
• Review for correct CPT/HCPCS coding
• Review for correct UB-04 Revenue Codes
• Review CDM for Modifier’s
• Review CDM for Description Issues and Missed Reimbursement opportunities
Admit Inpatient vs. Outpatient reviews and education
Work with Department Managers and CDM Coordinator to validate the accuracy of services charged.
A well-managed charge description master is the first line of defense against denied claims.
These services have a significant impact on reimbursement.
Contact information:
Angie Martin
cell- 785-214-2015
