Hospital Trauma Fees Are Under Scrutiny Our expert medical bill reviewer and clinical analyst recently identified a case where the application of a trauma activation fee was seriously questionable. Hospital trauma fees are under scrutiny across the country in general. Hospitals charge patients a trauma activation fee when they arrive by ambulance with a [...]
Duplicated Blood Work Sometimes in the course of a review, our coders are sent additional records from the hospital. Very often, charges for blood work are duplicated. When these go unreviewed, it means payors are charged twice for a single episode of blood work. In on specific case, our reviewer found 95 duplicate items totaling [...]
30 irregularly priced items! Our coding experts recently reviewed a claim and found 30 irregularly priced items. This occurs when different prices are applied to the same quantity of an item ad different points on a claim. For example, the claim under review listed CEFEPIME PER 500 MG at $106 which is the normal [...]
Another story of the dollar impact of inconsistent pricing. For today's Success Story we will be digging into some inconsistent pricing for just the medications on a large claim totaling $ 274,301.50. In the example below, you will see one of the categories under the global explanation codes we use at Hopewell as a [...]
During open heart surgery, it is the standard of care that the Anesthesiologist does blood gases to check the saturation of oxygen in the tissues. He starts an arterial line to draw blood gasses and labs during the surgery. This is a one time arterial puncture to float the arterial catheter in place. He draws [...]
Hopewell Risk Strategies Announces $1.6 Million Dollar Savings for Catastrophically Ill Patient Houston, TX - February 16, 2018 – Hopewell Risk Strategies (formerly Moody Review), part of the Hopewell Group family of companies, is proud to announce its recent success in saving over $1.6 million for its client and reinsurance partners for a single, [...]
If you process medical claims of any kind for payment, you already know the process is fraught with potential for errors and over charges. The challenge is that when your focus is on processing and payment, there’s less room for the necessary reviews and audits to catch and correct these errors. The downstream impact of this [...]
