Line-Item
Bill Review

H.H.C. Group provides:

Free Prescreens
Experienced Nurse Reviewers
Mediation Services Included

Line-Item Bill Review.

A majority of bill are cored. However, providers sometimes personnel make mistakes when entering information on a claims. Additionally, sometimes charges on the bills are out of line with what is being billed by other providers in the same market for the same services (Usual & Customary). For large out-of-network claims and in-network (when allowed) and, H.H.C.'s clients have us conduct Line-Item Bill Reviews (LIR) to determine the correctness of a bill and that the billed amounts are appropriate.

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Ensuring Bill Accuracy and Appropriateness

Line-Item Bill Reviews are intensive reviews performed by high-experienced nurse coders. They scrutinize every line on the claim to identify duplicate charges, improper modifiers, improper quantities, unbundling, and other errors. They also flag items that just don't belong on the claim. All to ensure that providers are paid a correct amount for the services they provide.

SPEAK TO A SPECIALIST

Determining Reasonableness of Charges

For out-of-network claims, we can also determine the usual and customary charges (U&C) for providers for the same or similar services in the same geographic area. Importantly, we perform a free pre-screen to determine if there appears to be errors on a claim which are significant enough to justify an in-depth review.

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Appeal Support from Day 1

Of course, should a provider have questions about any of the edits once the Line-Item Bill Review is completed and they receive a revised bill, H.H.C. works with both parties to help them come to an agreement regarding the amount the provider will be paid.

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Delivering Results Since 1995

H.H.C. Group is uniquely well qualified to provide this service given its:

29 years' experience successfully achieving mutually acceptable settlements for all parties on medical bills.
Experienced, attorney, licensed health insurance adjustor, case managers.
Proprietary database and access to multiple published databases.

We'll get the job done for you!