Medical bills often contain costly errors or the charges on the bills are out of line with what is being charged by other providers in the same market (Usual & Customary). For large in-network (when allowed) and out-of-network claims, H.H.C.'s clients have us conduct Line-Item Bill Reviews (LIR) to ensure they are not paying for items erroneously included in a bill.
Line-Item Bill Reviews are intensive reviews performed by high-experienced nurse coders. They scrutinize every line on the claim to identify duplicate charges, improper modifiers, improper quantities, unbundling, and other errors. They also remove items that just don't belong on the claim.
For out-of-network claims, we can also determine the usual and customary charges (U&C) for providers for the same or similar services in the same geographic area. Importantly, before asking our clients to commit a dime, we perform a free pre-screen
to determine if the potential savings are significant enough to justify an in-depth review. Of course, should a provider challenge any of the edits once the Line Item Bill Review results are sent to them by our client, H.H.C. offers appeal support starting on day one at no extra charge.
Some clients have us conduct Line-Item Bill Reviews that can be used in conjunction with Claims Negotiation and Claims Repricing:
- By Experienced Nurse Reviewers
- For Billing Errors
- For Reasonable and Customary Charges
- Free Prescreens
- Appeal Support Starting on Day One
today to learn more about how we can help!