BR Healthcare Services would work with the Hospital to perform a charge/chart audit. This would include an audit of patient charts, medical records, patient itemized billing statements, and third party communications and payments for a judgmental sample or statistically valid sample of inpatients and outpatients. BRHS would evaluate all third party payer types, Hospital Services such as Medical, Surgical, Cardiac, orthopedic, for both in and outpatients plus an appropriate number of outpatients based upon their classification of service.
The type of patient and payer class of the inpatient and outpatient samples would be discussed with Hospital personnel in order to reach an agreement on the make up of the review sample. To the extent possible the sample would include all payor types and all patient class of service rendered by the Hospital.
BR Healthcare will agree the items charged on the itemized bill with the other documents to determine the estimated frequency and dollar amount of unbilled charges. This review is not intended to be a compliance audit or to determine documentation for Medical Necessity of the treatments rendered.
At the conclusion of our review BRHS will render a written report as to its findings and recommendations. This report will detail the specific problems encountered during the review and, where appropriate, make recommendations for corrective action. BRHS will also include an estimate as to the recommendations total dollar impact on the Hospital.