ACL Allows Healthcare Agencies Identify Duplicate Patient Billings And Claim Payments

2011-01-01

Given the constant changes in the healthcare environment and growing complexity of regulations relating to electronic health transactions and information exchange, the need for effective compliance programs is more critical than ever. While the introduction of regulatory requirements have brought to the forefront the need for better controls systems and processes, healthcare organisations also face ongoing challenges in containing rising costs and improving operational efficiencies.

ACL’s powerful solutions allow healthcare organisations to quickly and easily access, compare, and independently check transactions from multiple application systems against control parameters, business rules, and historical data trends to identify errors, fraud and inefficiencies.

But don’t just take our word on it:

“An audit process that uses ACL technology is light years ahead of manual sampling. In the past, you’d have to hit the lottery to find something big. With ACL, we can find the root issues, identify trends, and provide our clients with detailed results.”

Jill Linden, Vice President of Operations, CHAN Healthcare Auditors

Contact us today to learn more about how ACL technology solutions can be used to:

• Analyse provider claims history relative to peer groups
• Identify indicators of over-utilisation, unbundling, and upcoding
• Identify invalid or high charges and incompatible coding
• Match laboratory procedure codes to appropriate billed charges
• Test for duplicate patient billings and claim payments
• Review single-day stays and same-day readmissions