Process

Bill Review & Chart Audits
HDM auditors achieve the most thorough results by scrutinizing, line-by-line, all items per itemized bill to check for billing inconsistencies and overcharges. HDM audits all types of bills including medical providers, inpatient facilities, durable medical equipment, dialysis, home health and other types. We compare the medical record, which includes doctor’s orders, nurse’s notes and various department reports, to the itemized bill to ensure that items billed were documented in the medical record.

DRG Validation
HDM analyzes 100% of DRG claims electronically. The result is an efficient and effective method for reducing DRG claims exposure. HDM's experienced audit team reviews designated claims and medical records to determine appropriateness of the DRG.