Services We Provide

Health Compliance Associates specializes in paid claims audits and chart audits for medical claims.  Our services can be broadly classified as:

  • Paid claims audit
  • Medical record & patient chart audit
  • Charge master rate increase audits

How Health Compliance Works

Paid claims reviews serve as compliance audits because Health Compliance identifies overbillings by applying not only the terms of the payer/provider agreement, but also the Medicare Conditions of Participation and the respective State Health Department requirements.

Health Compliance understands that overbilling patterns vary within hospital departments, such as radiology and nuclear medicine, among hospitals in the same network, and among networks in different regions. A major reason for erroneous hospital bills is the more than 10,000 different items in each hospital’s charge master.  There is almost infinite variability in hospital billing practices.

Health Compliance reviews 100% of the client’s paid claims and applies proprietary algorithms to identify potentially erroneously billed claims.  Health Compliance reviews documents supporting the submitted claim such as the medical record and the detailed bill.

Columbus, OH Office
3040 Riverside Drive
Suite 203
Columbus, Ohio 43221

(614) 487-8910 - Phone
(614) 487-8915 - Fax