This report combines the record review and med bill audit services into one streamlined report. Charges are substantiated by the record review and inconsistencies within the records are pointed out, including items related to or unrelated to the subject event. If there is over-use (ex: 3 MRI’s within a year) you would see that in the chronology of events.
Included in this report is a summary of medical bills by provider as well as a detailed provider audit summary and a chronological summary of the medical record, allowing you to look for overlapping medical care.
Required Records: All billing & statements including insurance EOBs and all medical records
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Organized Charge Data | ||
Billing Totals | ||
Total Reasonable Value | ||
Review for Duplication | ||
Review for Related Versus Unrelated Charges | ||
Audited Using Standardized Fee Reference Methodology | ||
Audited Using Standardized Fee Reference Methodology with Application of Geographic Modifier | ||
Line Item Commentary to Explain Reductions | ||
Compilation of Amount Paid, Adjusted, Paid by Patient, and Balance Due | ||
Review of Medical Record to Substantiate Services Provided as Necessary for MBA (Medical Bill Audit) Completion | ||
Medical Records Summary and Chronology of Pertinent Events | ||
Evaluation Conclusion | ||
Records Required | All billing & statements including insurance EOB's and medical records | All billing & statements including insurance EOB's and medical records |
Place your order via My.Ontellus portal. Select desired level of service; Identify records to be included; Securely upload files not already i your Ontellus case repository.
Within 24 hours, you will receive an estimate; We await your approval before proceeding.
We conduct our analysis and produce your report.
Your report is then securely delivered to your account via the My.Ontellus portal.
A Claim Evaluation is an intelligent and comprehensive report that provides a functional road map to the most productive defense strategy and a clear breakdown of the facts you need for effective negotiation, expediting settlement and reducing indemnity.
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