Middle
Find and address the root causes of revenue leakage
Many aspects of the mid revenue cycle — coding; charge description master (CDM) maintenance; charge capture; and clinical documentation — can contribute to revenue leakage, leading to:
- Less net revenue collected
- More medical necessity payer denials and underpayments
- Decrease in case mix index (CMI)
- More manual claim cleanups and edits and an increased cost to collect
These case studies highlight the real-world success some of our customers have achieved.
West Tennessee Healthcare > Mid-Atlantic client >Mid revenue cycle challenges can take significant time and money to reprocess or appeal. We can help. Our mid revenue cycle solutions include:
- Coder training and education
- Coding quality, documentation, and policy assessment
- Payer coding audits
- Interim HIM and/or coding management
- Evaluation and management (E/M) coding audits
- Charge capture audits
- Denial and appeal management, leveraging machine learning algorithms
- Inpatient/outpatient coding guideline development
- Clinical documentation improvement (CDI)
- Charge description master (CDM) review and maintenance
Discover denials best practices
We have solved denials challenges for hundreds of healthcare systems nationwide, and we want to share our time-tested best practices with you too.
Our denials playbook will help you:
- Identify and address your root-cause denials issues
- Dig deeply into prior authorization and eligibility, two key drivers of denials
- Harness the power of your data ... and your people
- Write more effective appeal letters by following our five tips
