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Bill Audits

Medical Management Services manages and services our Bill Audit product. Our Bill Audit is a cost savings tool which acts as an auditing system as well as a control mechanism for the payment of medical billing. It is often used in conjunction with a peer review to optimize the analysis of a case.

Our Bill Audit service compares pricing on CPT codes issued by the American Medical Association (AMA) to our database which contains a "usual and customary rate" (UCR) for each CPT code by geographical area. Our database utilizes the most current national pricing data combined with our internal Network physician’s model. These data sources combine to form a creditable re-pricing model for comparison purposes. In addition, our audits detect duplicate billing for CPT codes for the same patient on the same date of service and identifies them with the original billing audit number. Our audits are easy to understand and only show the actual savings from the codes that were reviewed. However there are much more savings achieved through the identification of incorrect codes and the control against duplication of payment.

In addition we make the data from your audits readily available to you. This unique feature is a helpful tool when discussing the reasonableness of fees with an individual provider. You will have the actual name of facilities and the fees that you were charged you at your fingertips.

Our product stands apart because of the ability to customize our programs to meet our customers needs, our guaranteed turnaround time on the completion of the audits and the valuable data that is available in our monthly reporting. An account representative is available to assist and coordinate the in-house processing of all Bill Audits.