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 [...]
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. [...]
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 [...]
