Business Process Review
This process review evaluates the physical system…procedures and tasks…for assignment/capture of charges to a bill from the time a patient is referred for a service or otherwise enters the care continuum (ER, etc.) to the receipt of a patient statement.
Incorporating such elements of risk management as process controls and accountability, the appraisal includes how claims move through the system (each “touch point”) from initial order and entry through account closure.
Coding inconsistencies as part of the charge acquisition and entry process are evaluated.
Identified process gaps are closed (such as missing redundancies)
Data integrity maximizes utilization of time and resources, ultimately decreasing cost and increasing margins.