MODIFIED LINE AUDIT (MLA)
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Inpatient hospital audit designed for facility bills less than $750k
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In or out of network application
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Compact results presentation in one Excel spreadsheet and Word document
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Physician specialist review used as needed to review medical necessity, length of stay, level of care and frequency of diagnostic testing (e.g., labs, radiology)
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Line Charge Audit verifies each line of itemized bill for actual performance, unbundling and correct coding
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Reduced turnaround time to customer
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Medicare pricing included at no additional charge upon request
Modified Line Audits (MLAs) are a key part of our efforts to contain costs for our clients. They are used typically for inpatient facility bills where the gross billed amount does not exceed $750,000 and are designed for concise presentation. We utilize three distinct review methodologies and conveniently consolidate the results into a single Word document and Excel spreadsheet. The combined presentation enables rapid turnaround time to meet claims payment deadlines.
Physician Specialist Review, RN Line Charge Verification Audit, and U&C Repricing (each element only if needed) are combined into one review. Our practicing board-certified physician specialists provide in-depth analysis of the medical records. Our RN line auditors and CPC certified coders document items billed with emphasis on unbundling and correct coding. We also include Medicare repricing if requested to serve as a baseline comparison method. However, not all review methodologies may be needed on all cases, so the MLA approach is flexible depending on type of case under review.