Allied Managed Care: Hospital Bill Audits


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Medical Bill Review	Medical Case Management	Medical Provider Network/PPOs	Utilization Review

Hospital Bill Audits

Early Return to Work Hospital Bill Audits Life Care Planning Management Essentials Nurse Case Management Peer Review	Value Added Cost Savings Allied Managed Care’s Hospital Bill Audit service provides evaluation of select hospital bills that are not subject to state fee schedules or Medical Provider Network (MPN)/Preferred Provider Organization (PPO) contracts. Features Line-by-line audits of bills that are not subject to state fee schedules or MPN/PPO contracts to identify overcharges and inconsistencies when compared to medical documentation in support of the charges Disallows charges for services that were not actually provided Disallows charges inflated beyond “fair and reasonable” and “usual and customary” based on the geographical area of the provider — AMC stands behind and defends all reviews on client’s behalf Benefits Explanation of Review (EOR) provided with Allied Managed Care’s recommendations for appropriate reimbursement Be confident that Allied Managed Care-audited hospital bills are fair and reasonable Pay only the lowest, most appropriate medical costs