The medical bill audit compiles all of the medical charges by provider which are reviewed and audited by billing professionals to establish a reasonable value of medical charges based on diagnosis codes, standardized fee references, NCCI edits and correct coding rules.
This audit is useful if you are looking for a compilation of charges, a transparent view of the bills and to determine if the bills are 'inflated'. This audit uses scientific methodology to establish reasonable value and validation of the charges.
Required Records: All billing & statements including insurance EOBs and all medical records
| Features |  Medical Bill Audit |
 MBA & Record Review |
|---|---|---|
| Organized Charge Data |  |
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| Billing Totals | |
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| Total Reasonable Value | |
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| Review for Duplication | |
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| Review for Related Versus Unrelated Charges | |
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| Audited Using Standardized Fee Reference Methodology | |
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| Audited Using Standardized Fee Reference Methodology with Application of Geographic Modifier | |
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| Line Item Commentary to Explain Reductions | |
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| Compilation of Amount Paid, Adjusted, Paid by Patient, and Balance Due | |
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| Review of Medical Record to Substantiate Services Provided as Necessary for MBA (Medical Bill Audit) Completion | |
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| Medical Records Summary and Chronology of Pertinent Events | |
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| Evaluation Conclusion | |
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| Records Required | All billing & statements including insurance EOB's and medical records | All billing & statements including insurance EOB's and medical records |
