Consulting & Auditing

ERN Onsite Compliance Audits and Consulting

Providers typically miss appeal positions and revenue opportunities in their Business Office and Patient Access Departments. Considering the many handoffs and steps to stabilize, request authorizations, admit, treat, document, code, and bill each patient, oversights can be frequent.

Using our unique onsite process, ERN can help. Most of our engagements identify revenue opportunities and develop powerful enforcement campaigns maximizing monthly revenue from at least $150,000 to $50,000,000.00 per project. Service areas offering the greatest potential for improvement include emergency admissions, poststabilization authorization/transfer protocols and medical necessity and surgery denials.

You will get:

  • An ERN Certified Compliance Auditor skilled in administrative laws to prevent unfair payment practices and negligent utilization reviews.
  • A detailed implementation plan with specific payor corrective action plans and recommendations.
  • A library of regulatory documents and forms (affidavits of compliance, appeal and demand letters, law appendices, etc.)
  • Continuation of monthly offsite audits (remote access by our team of experts to provide solid guidance for your PFS/case management team in the preparation of appeal positions and letters.)
  • Customized policies and procedures in the admissions, authorization, transfer and appeal process.
  • Patient/Provider hotline to refer disagreements of care and untimely authorization cases to our Intake Unit.

 

To schedule an onsite audit or in service visit,
call (714) 995-6900 ext. 6925

Contact us today to start your enforcement campaign.