SITUATION
A large health system in the Southeast deployed R1 DRG Validation across the vast majority of facilities and immediately saw increased recoveries. One division, however, was not initially included in the implementation because they had an existing prebill CDI vendor solution in place upstream.
SOLUTION
As a partner, R1 wanted to ensure the client was capturing every dollar and offered to review the data for any potential remaining exposure behind that well-known prebill CDI vendor. After an assessment, it was clear that R1 saw considerable revenue opportunity and the account team reached out to the Vice President of Revenue Cycle to discuss.
RESULTS
The client was able to recover more than $11M in the first four months after this scope expansion. The overall engagement continues to drive value as well, approaching $50M in the first year.
“It isn’t uncommon for our team and technology to find large revenue opportunities behind other vendors and even upstream prebill solutions. We cover the full coding lifecycle, so we know from experience where to look to best help our customers find success.”
Andrew Stieve, SVP Operations, R1 Claim Optimization
