Hospital bill audits save millions of dollars each year to help control premium
costs for group members. For this service, USAble Mutual Insurance Company uses several
vendors, primarily HealthDataInsights.
The audit company helps USAble Mutual verify hospital charges and
correct errors in hospital billing.
Claims submitted to USAble Mutual meeting certain criteria with charges
that are more than a certain dollar threshold amount are prescreened and sent
to the audit company, which determines if they are a good candidate for audit.
Auditors review hospital bills for reasonableness and flag questionable
charges. They conduct audits on site.