To maintain a secure environment, payment compliance is very helpful. All too often, due to the complexity in modeling reimbursement formulas, hospitals will accept underpayments. Lost revenue in hospitals is usually due to inaccurately managed care payments.
Having assistance during the initial notification and the exit negotiation is very helpful because the process can be so confusing. What is helpful about payment compliance is that the goal is to strengthen your revenue recovery and still leave you with the tools to defend and minimize future audits.
By using payment reviews and revenue recovery you can capture unbilled items and recover revenue. Being able to protect yourself from aggressive insurance audits can help you conduct comprehensive account auditing for documentation.
Contract compliance is important and payment compliance must be analyzed in the correct fashion for the best results. The payment compliance process begins with a performance of financial analysis on new and existing contracts. By assisting clients with payment compliance they will have help with contract negotiation from start to finish.
When dealing with managed care review people are looking for verification of CPI escalator payments. The next logical step would be a follow up and collection of underpayments if necessary. Helpful research also found here.