Our professional auditors – all registered nurses – thoroughly review the hospital records. They verify the accuracy of all charges and services on the itemized bill and that the procedures and items were received by the patient. Audits are conducted on-site at the hospital. We take pride in successfully obtaining a signed agreement from hospitals 98% of the time concerning our audit findings.
EPI has been providing audit services for over a decade. Based on those years of experience with hospitals EPI’s screener recommends an audit when the bill meets criteria established by EPI. During the screening process if questionable charges are identified the nurse screener calls the hospital for clarification. In some instances we are successful in resolving questionable charges without conducting an on-site audit. When this occurs a corrected UB 92 is obtained with a final report sent to our client. In addition, EPI will negotiate a fair settlement in lieu of audit should a hospital be unable to locate a medical record after a reasonable period of time.
EPI competently screens all cases received within 24 to 48 hours. The screener uses EPI’s database for auditing history and statistics with specific hospitals in respect to overcharges and unbilled or under-billed charges. EPI’s screeners have a medical background with wide experience in hospital services.
While our screening staff is in-house, they are in regular contact with field auditors regarding any changes at a hospital that might impact savings potential.
There is no charge for screening, obtaining medical authorizations, if needed, or securing interim or final itemized bills from hospitals.
EPI provides a final report and a hospital sign-off to document actual "net savings". In addition, customized monthly or quarterly reports provide clients with audit savings and statistics.