Revenue Integrity Solutions

We help providers bolster the middle revenue cycle to maximize revenue with an adaptable blend of leading edge technologies and expert people power.

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Confidently Ensure
Revenue Integrity

Our strategic mix of services and technology helps boost coding accuracy, improve clinical documentation, increase charge capture, and drive quality and compliance. We help healthcare providers apply efficient workflows and artificial intelligence to deliver coding expertise, recover revenue, and mitigate risk.

68%

of hospitals report that a revenue integrity focus increased their overall net collection

Triage Patients to Align Access, Setting, and Cost

Patients always have questions about their care, and they need a trusted, reliable source to guide them. Our Clinical Access and Triage Management Services enable you to align needs to resources by routing patients to clinically appropriate, cost-effective care settings.

Optimize Resources and Manage Costs

Clinical Access and Triage Management Services

Partner with a team of experienced clinicians

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Use Prospective Reviews to Deliver Appropriate Care

Our hospital Utilization Management Services help to ensure patients receive quality, cost-effective care while helping to reduce compliance risk and medical-necessity denials. 

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Utilization Management Services

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Manage Medical Authorization Across the Care Spectrum

Our Authorization Management Services manage pre-certification and authorization needs for inpatient and outpatient diagnostic and therapeutic services. We also provide comprehensive concurrent or retrospective inpatient authorizations after admission.

Optimize Reimbursement and Help Reduce Denials

Authorization Management Services

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Drive Clinical Documentation Improvement

Our experienced Clinical Documentation Improvement Services focus on improving the quality of clinical documentation and facilitate an accurate representation of healthcare services. Our process includes four key areas: (1) Identifying trends, growth, and gaps in diagnosis and procedures; (2) Concurrent or retrospective reviews of health records; (3) Providing education and best practices on querying and documentation; and (4) Facilitating collaboration among physicians and other team members.

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Clinical Documentation Improvement Services

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Access Medical Coding Expertise 

As reporting requirements and coding changes increase, many providers struggle to hire skilled professionals to focus equally on productivity and performance and to maximize revenue without compromising compliance. Our flexible Physician and Hospital Coding Services provide coding support during system changes, backlogs, and prolonged coder absences. Our team is proficient in multiple billing systems, making it possible to quickly deliver bottom line value while you focus on your core priorities.

Optimize medical coding accuracy and efficiency

Physician and Hospital Coding Services

Partner with a team of experienced medical coders

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Mitigate Risk with Quality Review and Education

Our Coding Quality and Audit Services help organizations mitigate risk by implementing quality review programs that verify accuracy and identify potential coding compliance issues. We then create education and compliance plans to drive continuous quality improvement in your organization.

Reduce risk and drive continuous quality improvement

Coding Quality and Audit Services

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Improve Charge Capture to Drive Revenue

Our Charge Capture Compliance Audit Services provide a comprehensive post-bill review to identify missed-charge opportunities. We perform a comprehensive claim, documentation, and process review to identify under- and over-billing. We then complete a root-cause analysis and create performance-improvement plans.

Bolster charge capture

Charge Capture Compliance Audit Services

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Strategies for Fine Tuning Revenue Integrity

There’s a lot of talk about healthcare organizations needing to improve revenue integrity to ensure compliance and realize strong financial performance amid changing payment models. But what is revenue integrity exactly, and how can organizations go about enhancing it?

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