Zero balance Forensic claims audit services
What is zero balance auditing?
A Zero Balance Audit entails a complete review of a provider’s processed claims. The primary goal is to identify any missed revenue, such as:
Underpayments due to incorrect contract interpretation.
Incorrect write-offs or adjustments.
Missed charges that were not billed.
Accounts settled for less than the contractual agreement.
We call this Revenue Leakage.
This detailed analysis empowers healthcare organizations to recover missing and lost revenue while gaining critical insights to prevent future leakage.
Why Choose PCG for Zero Balance Audits?
PCG Consulting brings a unique blend of expertise, advanced technology, and industry know-how to help healthcare providers maximize their revenue potential. Our approach is:
Comprehensive: Every account is meticulously examined to identify discrepancies.
Data-Driven: We use sophisticated analytical tools to uncover obscured patterns and ensure no detail is overlooked.
Collaborative: Our team learns not only your processes, but also how payors have adjusted to those processes – the provider payor arms race.
Proactive: Beyond recovery, we provide actionable recommendations to improve billing, claims handling, and contract management processes.
The PCG Methodology
Data Aggregation: We collect detailed claims data from your billing and revenue cycle systems, focusing on accounts marked as zero balance.
Detailed Audit and Analysis: Using advanced analytics, we review payment histories, contractual agreements, and billing records to identify discrepancies, underpayments, or missed charges.
Custom Reporting: We deliver comprehensive reports that outline our findings, detail recovery opportunities, and provide actionable insights to improve reduce and stop revenue leakage.
Revenue Recovery: Our team not only identifies underpayments - we also execute the heavy lift of working with payors to recovery the lost or missing revenue.
Continuous Improvement:With a focus on sustainable outcomes, we provide detailed information to stop the revenue leakage we find. In a perfect world eventually, there is no revenue leakage, and we are no longer needed.
Key Benefits of PCG Zero Balance Audits
Why Partner with PCG Consulting?
PCG Consulting is a trusted leader in healthcare consulting, offering innovative solutions to drive financial success. With decades of experience, a proven track record, and a commitment to community-driven excellence, we are uniquely positioned to deliver outstanding results.
Proven success in Zero Balance audits. With our partners, we have identified over $100 Million in revenue leakage in the last 7 years. (Commercial, Medicare, and Medicaid)
Expertise in payor contract compliance and national and state-level regulatory environments.
Advanced technology and data analytics capabilities.
A client-first approach focused on measurable repeatable processes and outcomes.
Secure Your Revenue with PCG Consulting
Partner with PCG Consulting to uncover missed revenue and ensure your organization is financially optimized. Let our Zero Balance Audit Services safeguard your bottom line and set your healthcare organization on the path to sustained success.