Nurse Bill Audit

Not all bills are alike. There are times when software fee scheduling (Provider Bill Review) cannot capture the savings that a nurse bill audit can provide. A Registered Nurse audits the medical bills from facilities, providers, hospitals, etc. to determine if the medical charges accurately reflect the procedures being performed. This is based on review of the medical records and billing codes – even for those codes (BR codes) not yet in the fee schedule.

Hands down… Managed Care Network has the best Nurse Auditor service in New York State…

  •  Our department has 20 years experience performing this service and has  expertise that no one can compare to

  •  In 2008, we audited 1,532 medical bills. Total Savings were $16,400,000. Total  Charges were $113,800. Return on Investment is: 144.1 to 1

  •  The average turn around time is 10 days unless “Rush” request is made. “Rush”  bills are turned around in 24 hours

  •  Managed Care Network has established relationships with the facility, hospital,  and physician groups leading to rapid securing of medical records

  •  Medical records are secured at no extra cost

  •  All follow up questions will go directly to Managed Care Network. That means  no follow up calls to you therefore saving time for your adjusters

  •  Due to our upfront negotiating, rarely is there a need for a second look. But if  this does occur, the Nurse will handle these situations for quick resolution

  •  Due to our accuracy, expertise, and understanding of bill audits, out of thousands,  only 2 bills have been disputed and gone to arbitration

  •  We have established relationships with bill coders at many facilities and  providers, and they respect our Nurse’s decisions

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