Medical Bill Review (audit) Services

The Medical Bill Review Process:

  1. AMPS receives claims via secure client portal.
  2. Each claim received is issued an AMPS control number.
  3. Client receives a daily report of claims in process.
  4. Payer or AMPS requests itemized bill.
  5. As needed, AMPS requests medical records on behalf of payer.
  6. All documentation is reviewed by our highly trained physicians reviewers.
  7. AMPS documents all clinical errors and services for which the patient received no benefit.
  8. AMPS documents adverse outcomes and "never events".
  9. AMPS documents coding errors and egregious charges.
  10. AMPS defends all recommendations with an aggressive Patient Advocacy Team and legal support.

The Medical Bill Review Savings:

This process results in significant savings to the payer and greatly enhances a Third Party Administrator's value to their clients.  Actual demonstrated savings from a client are shown in the following chart.

 

hospital bill audit healthcare cost containment fraud detection out of network claims employee benefits tpa third party administrator health plan self funded self-funded