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Ignoring small leaks of revenue could cost your health system millions of dollars and put your organization at a financial risk. It is unfortunate that arresting revenue leakage and assuring revenue integrity is discussed less than once a month in most revenue cycle teams. What’s even more disturbing is that as many as 60% of health systems lack a formalized revenue integrity program.

Some sources of revenue leakage are:

• Coding Issues including unbilled procedures and errors in coding leading to high DNFB Rate (Discharges Not Fully Billed)
• UB-04 form has 81 fields and even more subcategories that create a high probability of errors in claims submitted
• Issues in the set up on Charge Description Master (CDM) files
• Lack of staff training on causes of revenue leakage and clinical documentation
• Lack of a structured data-driven revenue integrity program
• Lack of structured payer contracting processes.

Taking a data-driven approach to arresting revenue leakage and assuring revenue integrity is of paramount importance.

EXPLORE OUR SUITE OF REVENUE INTEGRITY SERVICES AND SOLUTIONS

The first step in creating a revenue integrity program is to audit and determine the key sources of revenue leakage.  ZX Healthcare Solutions revenue integrity experts can help you achieve transformational results in terms of improved revenue realizations and profitability.

Our Revenue Integrity Solutions include:

Structured Revenue Integrity Program 

• We apply our services expertise and technology to improve coding accuracy, improve clinical documentation, reduce DNFB, improve charge accuracy, and apply our quality assurance processes & methods to improve compliance,
• Our analytics expertise enables us to pinpoint issues and implement sustainable solutions.

Optimize authorizations

• We provide technology-enabled precertification and authorization services for inpatient/outpatient services.

Clinical Documentation Improvement

We focus on improving the quality of clinical documentation and enabling clinicians to represent the healthcare services they provide accurately. Our CDI services include:

• Trends of specific diagnosis and procedures
• Gaps in clinical documentation for each diagnosis/procedure
• Sensitize clinicians to issues in clinical documentation
• Creating an ongoing dialogue between clinicians and team members

Our team of experienced professionals specializes in revenue cycle management, conducting thorough assessments and implementing strategies to maximize revenue and minimize revenue leakage. From charge capture to reimbursement, we identify areas for improvement and implement solutions to enhance revenue integrity.

In addition to revenue optimization, we prioritize compliance with regulatory requirements and industry standards. Our services include coding audits, billing compliance reviews, and staff education to ensure adherence to coding guidelines and documentation requirements.

By partnering with us, healthcare system providers can improve financial performance, reduce compliance risks, and enhance operational efficiency. Our solutions are customizable to meet the unique needs of your organization and can be seamlessly integrated into your existing workflows.

Experience the benefits of our revenue integrity services today. Contact us to learn more about how we can support your healthcare system operations and optimize your revenue cycle.