Hospital Bill Audit Services

The Issue
As insurance companies and employers look deeper for opportunities to reduce their medical costs, another area yielding potential savings is the actual comparison of the hospital bill to the medical record. In many instances, this comparison reveals billing errors such as services not delivered, multiple billing for the same item, unbundling of charges, mathematical errors and data entry errors.

The Solution
Hospital Bill Audit Services (HBA) is a post-payment service that can audit medical claims before or after they are paid. The analysis compares physician orders to billed charges. Hospital bill audits occur on-site at the facility, or via a desk-audit program if the facility agrees. Viant works with the facility to gain mutual agreement on services provided and reduced charges are confirmed with a signed agreement.. All hospital bill auditors have acute-care nursing experience and are successful on 80+% of cases.

Value Points

• Effective post-payment cost control for large facility bills with minimum repercussions
• High success rate and high average dollar savings per successful claim
• Signed agreement with provider on each claim; minimal appeals and back-end “noise”
• Ability to screen hospital bills before or after the claim is paid

How It Works
To ensure reimbursement is based on actual services rendered to patients, high potential claims are identified based on historical and claim specific criteria, then forwarded to an experienced Viant field auditor for a thorough line-by-line review of the entire hospital bill. The audit is conducted on-site at the facility, and mutual agreement on services and reduced charges is confirmed by a signed agreement from the provider.

Advantages

• Discount rates range from 3% to 10%
• The average dollar savings is approximately $3000 per claim
• The average success rate is approximately 80% for all service lines
• Scalability: Viant’s HBA Services reviews over $1 billion in claims annually
• Recovery of overpayments is an add-on service available to HBA clients

Summary
Viant’s Hospital Bill Audit Services provides a complete and reliable verification of bill accuracy by comparing the hospital's medical documentation against the itemized bill. Our HBA Services ensure our clients pay only for services rendered by combining extensive hospital experience with a thorough clinical review of the medical record.

To learn more about Viant’s Hospital Bill Audit services, call us today at 800.820.5824.