Revenue Integrity

Our Revenue Integrity Solutions help optimize the revenue cycle to recover net revenue, mitigate compliance risk, reduce A/R days and improve cash flow.

Correct problems that could cost you millions.

Considering one to three percent of net charges are lost to leakage, organizations can experience significant financial issues if strong revenue integrity programs are not in place. We can help drive compliance while delivering revenue-generating improvements in the following areas:

Chargemaster Optimization

Identify opportunities for improved compliance and consistency in billing structure, with management of any corrections or rebills.

Charge Capture

Identify incorrect coding and missing charges; review for net revenue potential. Analytical insights drive process change to help eliminate future missteps.

Contract Management & Modeling

Analyze managed care and government payer contracts. Model scenarios showing revenue impact of changes to insurance contracts, charges, coding and pricing.

HIM Coding Review

Analyze patient accounts and claims to determine proper use of CPT and HCPCS codes and DRGs.

Transfer DRG Review

Evaluate transfer-eligible accounts and identify potential missing reimbursements; manage Medicare rebilling.

Payment Variance Analysis

Identify incorrectly reimbursed or denied accounts and manage appeal process to receive correct payment.

Strategic Pricing

Analyze chargemaster, payer contracts and competitiveness to find areas of pricing opportunity and create pricing scenarios aligned with strategic goals.

Talk to our insurance experts

Speak with insurance experts and ask questions before finalizing your plans or if you want help regarding our services. Our dedicated staff is more than happy to call and guide you.