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 [...]
The Hopewell Group Announces New Workday NurseConnect Service For Immediate Release The Hopewell Group Announces New Workday NurseConnect Service Houston, TX - August 12, 2019 - The Hopewell Group is excited to introduce its new Workday NurseConnect service. Workday NurseConnect is a nurse triage line designed to improve access to health care advice. It [...]
The Hopewell Group to Attend the 39th Annual SIIA Conference in Sept. 2019 For Immediate Release The Hopewell Group to Attend the 39th Annual SIIA Conference in Sept. 2019 Houston, TX - August 26, 2019 - The Hopewell Group is excited to announce that members of the Hopewell Risk Strategies leadership team will be [...]
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 [...]
Small errors and inconsistencies can add up. In February one of our experts spotted pricing inconsistencies on a claim. Several injections were listed with different prices. The first Fluconazole Injection per 200 mg quantity of 2 was charged at $ 42.00. On four subsequent lines a quantity of 2 was charged at $ 54.00. [...]
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 [...]
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 [...]
