REVENUE
LEAKAGE

MINIMIZED.

Revenue Integrity

Increase your revenue today while protecting it tomorrow.

Improving revenue integrity is hospital executives’ top priority, yet many organizations never dig deep enough to correct sources of revenue leakage. Considering 1 to 3 percent of net charges are lost to leakage, it can cost your organizations millions—unless you have a strong revenue integrity program.

Revenue integrity is especially critical as value-based reimbursement (VBR) increases. With VBR, the charges captured today not only drive current revenue but also dictate target prices for future reimbursement. In both reimbursement models, ignoring small leaks can cost millions now and jeopardize your organization’s performance tomorrow.

R1’s Revenue Integrity Solutions help you attack revenue leakage to achieve the greatest value – by optimizing your revenue cycle holistically, from end to end.

Solutions that drive ease, efficiency and profitability

Dig deep and correct problems that could cost you millions.

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 reimbursement; 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.

Uncover your hidden sources of leakage

Get accurate reimbursement every time through R1’s Revenue Integrity Solutions:

1.5%

increase in net revenue

60 Days

to receive additional cash flow

150+

successful revenue integrity programs deployed

NAHRI Survey

Download the Latest Report On The State Of The Revenue Integrity Industry.
Does your hospital have a dedicated revenue integrity staff or does it employ a committee approach? Do you have a budget for revenue integrity education? How does your hospital maintain its chargemaster or address price transparency? Given the wide variation in the way revenue integrity is addressed in the healthcare industry the National Association of Healthcare Revenue Integrity (NAHRI) recently published a survey on the various trends and strategies hospitals across the country are adopting to optimize revenue and ensure compliance.

Get Report

Stop leakage with a strategic revenue integrity program

R1-WHY_FINAL

 

What R1 clients are saying

“R1 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."

Kim Shrewsbury

Kim Shrewsbury

Chief Financial Officer (former)
Ascension, Gulf Coast Ministry
Pensacola, FL

“The revenue integrity projects R1 has worked on for us are expected to generate $6.5M, which is over a .9% lift of our NPR. I would recommend R1 to any hospital system looking to boost their performance in the revenue integrity space.”

Brandon Williams

Brandon Williams

Chief Financial Officer
Ascension, Alabama

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financial performance and patient experience.

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