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
Download the playbook >