Services

Personal Scrutiny Proprietary Technology

Nurse Audit individually analyzes every claim—line by line—and compares it with our proprietary database of provider recovery history. This meticulous, research-driven process offers an extra level of claim screening that enables us to detect overlooked errors—and uncover opportunity—for our clients.

Our state of the art in-house computer system is driven by the latest technology available, enabling an electronic interface with our clients through all phases of the audit process, while still providing the personal touch only years of experience can deliver.

Cost Containment Programs.

• Pre-Payment Negotiation Services
• DRG Validation Program
• Inpatient and Outpatient Provider Bill Audit Program
• CPT Code Review with Claim Analysis Program
• Contract Compliance Audits
• Workers Compensation Bill Analysis Program

Program Compatibility.

We work with virtually all reimbursement methodologies including:

• Discount off of charges
• DRG
• Stoploss thresholds
• Carved-out reimbursement
• CPT based fee schedules

Consulting Services.

• Audit Policy Development
• Provider Payment Policy Development and Implementation
• Contract Language Enhancement and Development

Customized Solutions.

Motivated by a desire to creatively serve our clients, Nurse Audit customizes unique programs and provides valuable consulting services-thoroughly and creatively.