Protect
valuable revenue.

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

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Accurate reimbursement always.

By leveraging advanced technology and analytics paired with extensive project management and healthcare expertise, our providers can ensure complete reimbursement is received for the care provided.

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Less risk,
greater reward.

We help health systems achieve significant revenue lifts by building a solid and compliant foundation for pricing, coding and charging.


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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.

Supercharge the revenue cycle.

R1 Intelligent Automation fuels our ability to deliver differentiated value – reduced cost and waste, greater profitability and a better patient experience.

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The results will amaze you.

Create a strong revenue integrity program that meets critical KPIs.


REVENUE

INCREASED.

1.5%

increase in net revenue


CASH IMPROVEMENT

ACCELERATED.

60 days

to receive additional cash flow


PROGRAMS

DEPLOYED.

150+

successful revenue integrity programs

Ready to talk?

Learn how we transform the revenue cycle with solutions that streamline the
patient experience, drive operational efficiency and improve financial performance.