196 Charmant Drive,
Suite 3
Ridgeland, MS 39157

Phone: 1(601) 366-3669
Toll-free: 1(800) 748-8773


Bill Audit

Hughes & Associates' unique hands on approach has been designed to review claims information, analyze the relationship of coding within a claim and set an open standard for correct coding. The HCFA-15-- and UB-92 claim forms are reviewed by nurses possessing extensive code review experience. For every claim, an RN will identify coding problems such as unbundling, valid diagnosis, place of service, assistant surgeon, cosmetic surgery and medical necessity.

Physician reports, operative records and diagnostic charts are reviewed for consistency with charges itemized on the medical claim.

Hughes & Associates' also provides other important bill audit services to help employers and payers monitor the appropriate reimbursement for medical claims.

  • CPT-Code Review
  • Medical Necessity Determination
  • Appropriateness of Charges
  • Relatedness of Charges to Work Injury
  • Fee Schedule Re-Pricing
  • Usual and Customary Pricing
  • Negotiated Discounts for Non-PPO Charges
  • Multiple Code Appropriateness
  • Specific Savings Reports
  • Return on Investment Reports

Call Leo Hughes to get a quote on the "Flat Rate Per Bill" charge that combines all Bill Review and Precert Charges into one simple per bill charge.