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Revenue Recovery
American Health Technologies
We are specialists in Revenue Recovery and have created new processes suited for the unique requirements of Medi-Cal, Medicaid and Medicare.
Transfer DRG Audit Service rapidly processes, identifies, corrects, and bills claims with our data mining cascading processes which are the best in the industry. We have processed Transfer DRG data that other vendors have processed and continually find additional underpayments.
Self Pay Audit Service processes data in a unique way that separates AHT’s technology and processes from other vendors. AHT’s automatic eligibility and claim status processing program identifies existing Medi-Cal, Medicaid and Medicare enrolees missed by most eligibility verification service providers. AHT’s technology based solutions provide a dramatic improvement in the management of Self Pay accounts.Pharmacy Audit Service is a non-disruptive process that allows the Hospital Pharmacy to follow a checklist of downloads of basic prescription data from the Hospital Pharmacy System and assists the Hospital in recovering ALL money lost.
Financial Review Services
We provide clinical expertise to the administrative side of the business and help extend the administrative and accounting controls. Charge capture improvements and revenue recovery are the results of our efforts.
We identify weaknesses in the charge capture system in surgery, pharmacy and the endo lab, recover lost charges, and help the client improve the charge capture steps. This “find out what needs improvement and help fix it” approach offers the best value to the client because the client gets the help it needs quickly.
FRS’ business approach is to focus on fixing problems, not on auditing and auditing and auditing as others in this field do.
As a follow-up service, after the charges are being captured properly, we provide a managed-care payment review. This involves:
- recalculating what you should have been paid under your various managed-care agreements;
- comparing your actual receipts to what you should have been paid;
- recovering underpayments from the carriers.
HCFS, Inc.
HCFS, Inc. contracts with hospitals to assist with eligibility services, out-of-state medicaid billing, workers’ compensation billing, follow-up services and point of service collections.
VARIS
Our Team’s experience spans the breadth of environments from the payer, to the provider, to the Peer Review Organization (PRO), and possesses an intricate knowledge of health information management and the ICD-9-CM and CPT-4 coding system, the backbone of hospital payments.