How We Can Help | Uncovering a Complete Picture | Three Step Process
Through an initial interview with management and staff, Chapin reviews your facility’s processes, procedures, contract structure and level of managed care penetration. This complimentary review indicates whether to proceed to the next step, a sample audit.
If warranted, a statistical sample of paid managed care accounts is then reviewed. This sample audit is performed at no charge or for a nominal cost that can be credited against any recovery fees. The bulk of the work is done off site, allowing your staff to work uninterrupted. When complete, you will receive a detailed report of our findings. If your report shows little or no variances between what was collected and what should have been collected, then you can rest assured that your bottom line is as it should be. If, however, variances are found, the report will identify the percentage of your accounts with potential variances as well as specific payers. A determination is then made as to whether to proceed with a recovery project.
The recovery project itself begins as we create and copy a UB print image file from your billing system. Contract terms and print image information is loaded onto our system along with payment data. Chapin’s UB Master software calculates expected reimbursements based upon the appropriate contractual terms. Payment variances are calculated and investigated to eliminate any false claims due to such items as patient responsibility and cross registrations. A determination is then made as to whether the appropriate payment was received. True underpayments are documented and presented to managed care payers. Chapin continues to follow up with the payer until the underpayment is resolved. As our fees are contingency-based, we are only compensated when we recover money for you.
Contact Chapin about Audit and Recovery Services
For further information about Chapin's customized solutions, contact Rick LaForge (rlaforge@chapinrcm.com).
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