Revenue integrity services include charge capture and optimization; CDM improvement and maintenance; strategic pricing; and Transfer DRG audit and reclassification as appropriate.
We leverage a rules engine that is the product of over a decade of operational experience improving revenue integrity in well over a hundred hospitals. Services are delivered by a team of highly trained specialists, aligned by function and service modality to ensure highly accurate and value-added improvements to the integrity of your billed revenue. Lastly, our platform offers analytics and visibility to give you insight into root cause opportunities and reimbursement trend.
This will be our 4th year partnering with R1, who has helped find additional dollars in net revenue for our health system. Projects such as CDM optimization, coding/charging review, and TDRG have generated over $10M in additional net revenue since their start. Those projects are projected to produce over $3M in net revenue again in 2018, which is over a .4% lift on our NPR. Their monthly reporting allows transparency to the actual cash collected from these projects and can even get as granular as reporting the actual cash collected on a specific account.
In addition to finding and uncovering net revenue for our organization, they work closely with our clinical and corporate teams to educate and correct billing and coding practices on the front end to mitigate downstream issues. I have really enjoyed the relationship created between R1’s team and our local teams at Pensacola to generate such great results.
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