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Medical billing auditing method and system

  • US 8,010,384 B2
  • Filed: 10/30/2007
  • Issued: 08/30/2011
  • Est. Priority Date: 07/28/2005
  • Status: Expired due to Fees
First Claim
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1. A method for assessing billing compliance of a medical related decision prior to the medical related decision being finalized, the method comprising:

  • receiving the medical related decision inputted by a medical professional using a user interface;

    applying at least one rule to the medical related decision, the at least one rule being stored on a memory and accessible using the user interface;

    auditing the medical related decision for compliance with the at least one rule;

    providing results of the audit prior to the medical related decision that is inputted by the medical professional is finalized so that the medical professional can finalize the medical related decision based on billing compliance;

    wherein the results include an indication of billing compliance or billing non-compliance of the medical related decision with the rules;

    wherein an indication of billing non-compliance of the medical related decision that is inputted by the medical professional is presented to the medical professional prior to the medical related decision that is inputted by the medical professional is finalized so that the medical professional is prevented from making the medical related decision if the indication of billing non-compliance is provided to the medical professional;

    wherein an indication of billing compliance of the medical related decision that is inputted by the medical professional allows the medical related decision that is inputted by the medical professional to be finalized; and

    wherein the steps of receiving medical related information, applying the at least one rule, auditing the medical related decision and providing results of the audit are carried out on a computer.

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