Health Care Compliance Consulting
If not managed correctly, the regulatory environment can become costly for hospitals and other healthcare organizations. Penalties or fines for noncompliance can have a significant impact on your bottom line. Furthermore, failing to meet regulations can trigger an audit.
CBIZ healthcare compliance services help address forms of compliance risk, from coding to patient management and revenue cycle analysis. We identify the areas where your compliance functions could be improved and help you identify opportunities within your current functions to retain and enhance your revenue.
Learn more about how we can assist you in navigating your complex regulatory environment.
- Clinical Coding: Our team uses clinical and financial expertise to assist you throughout the reimbursement cycle, helping identify revenue-enhancing opportunities.
- ICD-10 Services: Through our ICD-10 services, we review where you may be leaving revenue on the table.
- Medical Necessity Services: We help providers avoid denials and suspended claims by assessing the potential compliance risks.
- Observation & Two-Midnight Rule Services: Our S20 Monitor service helps health care providers reduce risk and regulatory compliance issues related to short stay admissions and observation status.
- RAC Services: The suite of services we provide for Recovery Audit Contractors assists with clinical coding and documentation, medical denials and appeals, patient accounting and health information accounting among other functions.
- Revenue Defender: Our non-invasive, cost-effective solution uses a five-step process to diagnose the scope and breadth of revenue compliance issues while working to reduce your compliance risk and protect entitled revenue.
- Utilization Review & Case Management: Our team of registered nurses leverages their experience in both the hospital and payer environment to provide a range of consulting services, including education and instruction, inpatient medical necessity reviews, short stay medical necessity reviews and emergency department case management services.