Revenue Integrity

Revenue Integrity

A lot of organizations do not have the resources or the time to research enough to find and plug all sources of revenue leakage. While it may sound insiginificant, just 1-3% loss of net charges can translate to a loss of millions of dollars for your organization.

With value-based reimbursement (VBR) becoming prevalent, the charges captured today drive not just your current revenues, but will also set the tone for future reimbursements. If you do not fix these leaks now, it could mean the difference between surviving and collapsing in another pandemic situation like COVID. An ever more competitive environment and unforeseen circumstances mean that saving for the rainy day is more important now than ever before. We are sure, you don’t like leaving money on the table!

Experience with over 30 different billing platforms

314e can help you with a variety of services to ensure revenue integrity.

Optimize Chargemaster

We will help you identify how and where to locate the proper revenue codes, how to identify accurate codes to bill and the correct reporting of all separately identifiable procedures. We ensure that payer contract data is up to date in the charge master and the billed amounts are set to maximize reimbursement.

Accurate Charge Capture

We will help you identify incorrect coding, modifiers and missing charges, modifiers, NDC etc. We check every claim against CCI Edits, NCDs and LCDs for net revenue potential. Corrective and preventive actions are taken with the help of data modeling and analytics.

Coding Review

Our certified coders will analyze patient charts and claims to determine appropriate use of ICD/CPT/HCPCS codes and DRGs. Coding related denials are looked at with a magnifying glass to ensure corrective actions are taken at the earliest possible.

Under-payment Analysis

We use big data analytics to identify under-payment tactics by insurance companies and manage the appeal process to receive the full payment you deserve.

Are you paying too much for your billing service?