revenue integrity optimization

We quickly fill your staff vacancies with our team members to temporarily backfill your patient financial staffing needs.

Rapid and Sustainable Revenue Improvement.

Our detailed hands-on approach to charge capture has added up to a 5% increase in annually recurring net revenues for our many clients across the country. Our approach has demonstrated significant financial benefits across all of the major billing platforms including MEDITECH and Cerner.
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Most organizations fail to capture at least 1%-5% of their chargeable services provided to patients in their health systems. This represents a significant leakage of net revenues for hospitals across the country. With continuing shrinkage of net margins for hospitals post COVID19 and the continuing pressures on the overall US economy, it is important that hospitals optimize their capture of charges for billable services to maintain their financial viability both short and long-term.
We work interactively with the clinical departments, revenue cycle and revenue integrity to identify areas of revenue leakage due to ineffective charge capture. These areas of revenue leakage can include non-optimized charge master, ineffective linkages between the various charge capture systems, ineffective clinical department charge capture, and non-optimized overall revenue cycle. We also provide monitoring tools and assist with implementation of the identified opportunities.
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+5%
Our detailed hands-on approach to charge capture has added up to a 5% increase in annually recurring net revenues.
1%-5%
Most organizations fail to capture at least 1% of their chargeable services provided to patients in their health systems.
ANALYTICS
  • Perform Assessment of the Charge Master and RelatedData
  • Analyze charge master for coding accuracy
  • Validate linkage between the various charge capture mechanisms such as patient access system linkage to the ancillary department system, charge master and finally the billing system
  • Identify potential revenue leakage areas prior to on site/virtual clinical department interviews/walk-throughs
POST INTERVIEW DATA ANALYTICS
  • Perform various data analyses to validate previous work steps
  • Perform claims analysis, when appropriate, to validate charge master issues with various payors
  • Develop a list of revisions/additions/deletions to system interface linkages to optimize system performance
  • Develop a list of charge master changes by clinical department for review with key stakeholders
  • Quantify financial impact of identified charge master changes
DATA VALIDATION
  • Perform on-site/virtual interviews with clinical departments, HIM, Revenue Integrity and Revenue Cycle
  • Through the walk-through process and interviews with key stakeholders, identify revenue leakage areas in the charge capture process such as inaccurate charge capture system interfaces and ineffective charge capture processes
MITIGATION
  • Implement action plan with points of accountability
  • Review go-forward reporting and analytics
  • Identify new trends before they become an issue

The financial success of an organization is directly linked to the accuracy of the organization’s charge master.

We work interactively with the clinical departments, revenue cycle and revenue integrity to identify these gaps and provide solutions that result in sustaining long term the net revenue opportunities identified in our analysis.

We also provide monitoring tools and assist with implementation of the identified opportunities.
Download Charge master Assessment PDF

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