The first auditing software that identifies Medicare billing errors and helps meet OIG compliance guidelines.

Every year, hospital and independent laboratories lose millions of dollars in revenue and run the risk of enormous fines due to mistakes in Medicare billing and compliance procedures. Yet only a small fraction of laboratories conduct the kind of probe billing audits that would identify errors and demonstrate compliance with OIG regulations.

Now those probe audits can be done quickly and inexpensively with MediBill Analyst, from Health Systems Concepts. This software automates the probe auditing process with results that meet or exceed OIG standards. Most importantly, it allows you to document compliance oversight to reduce culpability.

Identify root causes of billing errors MediBill Analyst automatically finds and highlights problem records:

  Tests conducted but not billed
Tests billed but not conducted
Tests for which Medicare should have paid more or less than the actual remittance

Only MediBill Analyst conducts an automated 7-point validation check for every audited record:

  Did the laboratory perform the ordered test?
Did the test results match the test’s billing code?
Is the test a billable covered service under Medicare?
Was the CPT or HCPCS code correct?
Did the payment match your state’s Medicare fee schedule?
Were the diagnosis codes and other required billing information accurate?
ICD-9 codes against laboratory NCDs and Medicare payer-specific LMRPs

Only MediBill Analyst provides all the data you need to maintain an effective billing compliance program:

  Identify areas that require additional training
Find weaknesses in the structure or content of electronic documentation
Validate appropriate coding for services listed on the Laboratory Charge Master
Identify potential problems in documentation