Line By Line Audits Spot check Pricing accuracy Variations of pricing Adhering to the fee schedule Utilization of the best PPO network Appropriateness of outpatient reduction Appropriateness of inpatient reduction Spotting errors i.e.: Duplicates Reconsiderations Down coding Up coding Pricing

Steps for auditing

• Making sure that the bills are re-priced to the fee schedule
  
  
• Checking for errors such as duplicates, reconsiderations, down coding, up coding, pricing
  
  
• Checking if different variations of pricing would better suit the client
  
  
• Making sure that they are set up with the proper PPO Network that would provide the best outcome of reduction
  
  
• Making sure that when outpatient bills are reduced, it is done in compliance with the law and defendable in court
  
  
• Making sure that the client receives the best in-patient pricing by utilizing our Cost Containment strategies