This service provides medical billing reviews and audits for past medical bills to determine if the bills presented are both reasonable and meet the community cost range of other providers in the same geographic area. Our auditor has experience in both providing the analysis and also testifying to the results in a court room or arbitration hearing. There are several types of analysis provided:
1) Usual and customary review, 2) Medical analysis for appropriateness and 3)Medical billing review in conjunction with a medical record review to ensure that the billing was appropriate and reasonable for the services provided. These services are usually obtained by attorneys for litigated cases, trust companies, insurance companies, and private individuals.
Our nursing staff attends both plaintiff and defense medical examinations to ensure guidelines and appropriate testing is completed during the examination. The recorded examination is downloaded as an MP3file to be sent to you following the examination. If needed, the witness will serve as an expert witness at depositions or trials concerning the examination.
Each medical file is reviewed for content and summarized to be used both in reading the file, sharing with other experts, or determining the need for services. Each report is reviewed by a registered nurse, who has more than 35 years of experience with medical records. This saves extensive charges by physicians or other experts to review extensive records, allowing them to concentrate on the areas that are important to the case.