Bill audit

What a bill audit covers

You send the itemized statement, or the summary if that is all you have. We read every charge against the date of service, the units billed, and your explanation of benefits if one exists. Duplicate lines, inflated unit costs, pharmacy items billed twice, and services that never appear in the visit record get flagged before anyone treats the full amount as settled. This is financial advocacy, not medical advice. We do not decide whether a procedure was medically necessary. We decide whether the paper in front of you is an honest account of what was billed.

How it works

Upload the bill you received. If it is a one-page balance due, we request the itemized version from the provider so the review is not based on a total with no codes. Then we walk each line: date, description, CPT or revenue code, units, and what the plan already allowed if an EOB is in the file. The first review is free. If the audit shows work worth doing, we present the fee as a percentage of documented savings before you authorize anything. You can stop after the written outline. Nothing is billed for a review that does not proceed.

A useful audit is specific. We mark the page and the line, not a vague note that the bill looks high. Facility fees sitting next to professional fees for the same minute of care, trauma activations stacked on a standard ER evaluation, and supplies billed both as a kit and as each item inside that kit are the kinds of repeats that show up once the statement is actually itemized. Ambulance mileage that cannot match the trip, labs drawn twice on one timestamp, and pharmacy lines that also appear under the ER department are written into the outline so you can see the dispute in the same order as the bill.

The summary is not the bill. The itemized statement is. Until you have both, you are guessing what you owe.

You keep control of the file. The outline lists what we can dispute, what still needs a document from you, and what looks correctly billed so you are not arguing lines that will not move. If we cannot reduce the amount, you owe nothing. If we can, the percentage is shown in writing before advocacy starts. Results vary by provider policy, the statement, and your situation. No one here quotes a dollar target off a first look.

You get a written outline of what we found and what we can dispute, tied to the account number and date of service on your statement. Cerapex provides financial advocacy services, not medical advice. We do not comment on whether a procedure should have been performed. We document billing errors, mismatched codes, and charges that do not belong on the patient share so you can decide the next step with the paper in front of you.

What we look for

• Line-by-line review of the itemized statement, not the summary
• Duplicate, unbundled, and inflated charges flagged in writing
• Comparison against your EOB so denials and patient-share math are visible
• A written outline of what we can dispute before you authorize advocacy
• You pay a percentage of documented savings only if the audit leads to work

Who it is for

This work is for anyone holding a hospital, ER, surgery, ambulance, lab, or specialist bill they cannot pay in full, or who suspects the statement is wrong and does not want to argue with billing alone. It is also for people who only received a summary total and have not yet seen the itemized file. If you can pay the billed amount without hardship and the lines already match your EOB, you may not need an audit. If the number on the page does not make sense, send it.