Stand-alone payment variance tools and similar programs that are components of patient accounting systems can be a valuable part of auditing contractual payments. However, sole use of a software program to identify payment variances puts providers at risk for losing substantial reimbursement.
When these systems are used in conjunction with a review of payments
by an independent third party, providers are likely to collect
substantial additional reimbursement. In fact, an industry best
practice is to use a payment variance program and to engage a separate
firm to conduct a zero balance review. This approach will:
Here are some of the frequently used systems and programs that help
identify payment variances:
