Hospital Audits
Very recently, there has been a resurgence of the
hospital audit within the cost containment arena in part as a result
of hospital over billing, particularly in the area of pharmacy
charges. Accordingly, guidelines involving hospital audits have been
revised.
When charges are believed to be excessive, the results of a hospital
audit can be utilized as a benchmark for provider negotiation. If an
audit is requested, a provider agreement outlining the adjusted
charges must be obtained. The agreement should also establish a
definitive timeframe for payment and include an agreement to not
balance bill the patient. Reimbursement of audit fees is limited to
25% of savings.
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