Clinical Auditing

Clinical audit is the base from which Advanced Reimbursement Management was built. For fifteen years, Advanced Reimbursement Management has provided audit services to hospitals for all payor types. Utilizing our core team of Registered Nurses, we save hospitals money every day by providing true experts to represent their interests in the following areas:

• Defense Audits: Defending hospital charges with commercial contract payors.
• Stop Loss/Carve Out Audits: Pre-bill auditing of accounts near stop-loss threshold to ensure all appropriate charges are included and that “special charges” are applied appropriately.
• Charge Hold/Lost Charge Audits: Review and adjustment of questioned or misapplied charges.

In all of these areas, Advanced Reimbursement Management provides data to the hospital on findings for use in process improvement and/or compliance activities.