A recent patient had a diagnosis of viral infection. Our expert coder did not have the lab report, or the medical record to base their evaluation on. The invoice was taken at face value in the dosing of this drug and stated: Cefepime HCL 2 grams vial at quantity of 4 with the cost of [...]
Coding Errors In a recent example of coding errors, a patient was charged with Piperacillin 3.75 grams at quantity 9 times a day for 4 days during an inpatient stay. This would be and overdose of 22 grams! The normal dosing is every 6 to 8 hour every 24-hour period, not 9 times a [...]
One of our medical bill verification experts, Maureen Callahan, recently caught some billing errors that could have easily been missed in a standard review. There were therapy charges on a facility (hospital) where the hospital billing department charged $278.00 for a 15 minute increment just for the therapist walking in the patient’s room. After reverification of [...]
An Insider’s View: Fighting Fraud and Abuse and Protecting Patients People fighting fraud and abuse in the medical reimbursement system have a tough job. It is like an iceberg, where what appears to be a small and harmless chunk of ice, hides a mammoth problem just below the surface. Finding these problems makes me [...]
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 [...]
