The need for change.
The Healthcare industry is constantly changing.
National Audit excels at staying ahead of these changes
by creating cutting-edge health claims auditing programs
that address the most prevalent causes of health care
overpayments.
The need for flexibility.
These highly customized programs and flexible
processes have resulted in unprecedented success and explosive
growth, making National Audit one of the most respected
names and a leader in its industry.
The need for growth.
We would like to re-introduce you to the company that is changing the face of auditing...we
would like to introduce you to: National Audit.
 Payment validation
services offered by National Audit benefit all types of healthcare
payers including:
Health Insurance Companies
Health
maintenance, point of service and preferred provider
organizations including managed care organizations.
As a claims payer, your company is subject to receiving and processing health care claims which are
potentially inaccurately coded and/or billed resulting in costly overpayments.
As the industry faces increasing health care costs and quality of care expectations, it is essential that
insurance companies make every dollar count. Overpayment exposure can be limited and possibly eliminated by
conducting claim validation audits.
National Audit designs client-specific payment validation programs which assist in identifying charges billed
for services not provided as well as those erroneously billed or administered. Audits will validate providers’
Diagnostic Related Grouping (DRG), Current Procedural Terminology (CPT) Ambulatory Payment Classification
(APC) coding, hospital bill, high cost drugs, skilled nursing facility and durable medical equipment (DME)
charges.
Third Party Administrators (TPA)
As in the case of health insurance and managed care organizations, TPA's are entrusted to properly allocate
and administer available health care dollars. Ensuring accuracy and limiting the overpayment exposure of
health care claims is in every TPA client’s best interest.
National Audit can provide your organization with the ability to deliver efficient and effective claims cost
management services to your self-insured clients.
Self-Insured Groups
Much like a health insurance company, self-insured
organizations carry the burden of being liable for any
health care expenses of their insured population. However,
oftentimes a self-insured group is far smaller in size than
a health insurance company. Therefore, catastrophic
losses can have a much more detrimental effect on the
financial health of a self-insured organization since the
losses can not be spread out over a large population.
It
is for this reason that it is even more critical for
self-insured groups to engage in the same health claim
auditing activities as health insurance companies. National
Audit can help self-insured organizations identify health
claim overpayments, thereby minimizing the dollars going
toward health care expenses.
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