National Audit has recognized the desire by health claims payers to review as many
hospital claims as possible in order to ensure accurate billing by hospital facilities
and the resulting proper payment. As such, National Audit has created an
audit program to ensure that health claim payers are maximizing the
number of hospital claims it reviews for proper payment.
The National Audit Itemized Bill Review (IBR) program is an adjunct
to the Hospital Bill Audit program. The IBR program assists payers
by conducting an in-depth review of claims that are not candidates
for the Hospital Bill Audit program.
Registered Nurses perform a line-by-line analysis of the itemized
bill to identify possible inappropriate or incorrect charges on
inpatient and outpatient claims. The reviewer contacts the provider
to clarify any identified issues and obtain a signed agreement which
highlights adjustments to the claim.
