Medical Bill Review: How Much Scrutiny Is Enough?

Manually reviewing a subset of medical bills that are processed through automated bill review can help weed out billing errors, abuse and fraud, experts say, but what percentage of medical bills should be subject to the more thorough but costlier manual review is a matter of debate. The subject was the topic of a webinar on Wednesday hosted by Verscend Technologies, which provides automated bill review and also offers “clinical validation” of billing by nurse-coders. “The well-intentioned focus on auto-adjudication (of medical bills) has allowed known waste and abuse to...