By Victor Sterling, MS, CHDA | Certified Health Data Analyst & Pricing Arbitrator Hospital Revenue Cycle Forensics | Lump-Sum Settlement Arbitrage & Medicare Cost-to-Charge Benchmarking Armed with Medicare allowable benchmarks and dedicated cash capital, patients can negotiate massive write-downs directly with hospital finance supervisors. When an unexpected medical emergency, hospital stay, or surgical procedure leaves … Read more

By Victor Sterling, MS, CHDA | Certified Health Data Analyst & Pricing Arbitrator Federal Balance Billing Forensics | 42 U.S.C. § 300gg-111 Enforcement & Independent Dispute Resolution (IDR) Defense Under federal statute, out-of-network balance billing is illegal for emergency encounters and non-emergency care delivered at in-network hospitals. When the landmark federal No Surprises Act (Public … Read more

By Elena Rostova, MHA, CPC | Certified Professional Coder & Health Policy Analyst Forensic Hospital Revenue Cycle Auditing | Chargemaster Anomaly Detection & CPT Code Reconciliation Hospital Revenue Cycle Management software automatically converts clinical charting into billable CPT and Revenue codes that can quietly double your charges. When you undergo treatment in an American hospital, … Read more

By Elena Rostova, MHA, CPC | Certified Professional Coder & Health Policy Analyst Forensic Hospital Revenue Cycle Auditing | UB-04 / CMS-1500 Reconciliation & Unbundled Chargemaster Dispute Requesting a fully itemized UB-04 statement with billing codes is the single most effective action to dismantle inflated hospital charges. A few weeks after an emergency room visit … Read more