Charge Capture Optimization

Leverage AI to realize 2% more revenue by ensure missing billable services are captured before claims are submitted for reimbursement.

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POWERED BY AI

Reduce Charge Capture Leakage & Capture 100% Billable Events

Accurately record and bill for all services provided to a patient to ensure accurate compensation for care provided.

AI flags bills with missing charges & charge errors

We leverage our our charge capture technology, ChargeView, powered by 1.5+ million algorithms, to identify all possible bills where a billable service was not captured on the bill, or captured incorrectly in a bill, before the claim goes out the door.

Our expert charge auditors identify services that can be added to the bill

Our expert charge auditors thoroughly review patient encounter records supporting the flagged bill to capture every single service that the provider is permitted to bill based on their payer contracts, while ensuring billing compliance with the charge description master (CDM).

Missing services are rebilled

Our team will validate all missed charges and can either provide an electronic handoff to your staff team to rebill or our team can update claims directly in your EHR.

Benefit from revenue lift from newly billed charges

Our charge capture optimization solution has been a key driver of our delivered revenue lift. We have been able to deliver operating margin improvement for clients, exceeding 2% lift over baseline revenue with smaller hospitals and outpatient providers seeing over 5% revenue lift.

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FIND THE MONEY

Discover More Billing Opportunities

Our initial assessment identifies charge capture improvement opportunities and provides a detailed roadmap for implementation with prioritization of initiatives for maximum optimization in the shortest amount of time. During this audit, we typically discover 12% - 16% of hospital outpatient bills are missing billable services.

Complete charge capture coverage leveraging technology plus experts

We provide a complete solution to execute these initiatives, including the technology platform, expertise and all needed charge auditor bandwidth to ensure every billable service on your bottom line.

Baseline each charge capture optimization initiative prior to execution

Clients receive a benefit acknowledgement form for each of optimization initiative, which documents performance baseline for that initiative and how we are going to measure benefit to your organization going forward.

Examples of areas where missing charges or errors are typically found

  • Supplies
  • Operating room
  • Pharmacy
  • Physical therapy
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OUR TECHNOLOGY PLUS OUR EXPERTS

Increase Revenue With Complete Charge Capture Coverage

Our charge capture solution includes:

  • Over 1.5 million charge capture algorithms
  • Charge auditor experts
  • Charge capture experts
  • Validation of missed charges
  • Real time performance reporting for agreed-upon charge capture initiatives
  • Analytics of gross charges, net reimbursement and new revenue
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HOW IT WORKS

Developed For Maximum Recovery

Our charge capture optimization solution is driven by a thorough assessment and intelligent workflows developed to drive consistent results.

Analyze

last 12 months of claims and payer contracts

Plan

initiatives to include missing billed services and prevent mischarges

Prioritize

initiatives to focus on in order of recovery value

Execute

charge capture to ensure all billable services get included

Optimize

workflows with actionable insights to improve charge accuracy

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CDM COMPLIANCE

Ensure Services Published In Chargemaster Gets Billed

In order to bill for a service, the charge needs to be in the provider’s published chargemaster.

When clients retain us, even though the service may be officially published in their chargemaster, billing staff still misses included that specific service in the bill after service is rendered which ends up resulting in that service not getting reimbursed. We help prevent this from occurring.

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QUICK ONBOARDING

Leverage Our IT Infrastructure

For those providers who have limited IT bandwidth to allocate to charge capture optimization right away they can lean on our team of data specialists who are experts with EHR and billing systems so all data and interface requirements are taken care of for them, without the need to divert current IT staff attention from ongoing responsibilities.

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PRICING

Pay For Only Billable Services We Discover

For any missing billable services our solution discovers, we charge our clients a percentage of the missing services or mischarges identified. We get paid only on the billable opportunities our solution discover

We also offer FTE support on monthly retainers to help with any charge capture workflow gaps your organization may be experiencing.

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Case studies

How We Help Our Clients

Learn how we work with our clients to solve their charge capture challenges.

How 3 Hospitals Recovered An Additional $1 Million+ With Charge Capture AI

Three of our hospital clients were struggling to pinpoint the reason behind lost revenue. With the overall staff shortages and complexity of charge capture, the hospitals were unable to resolve their missing claim charges. Using our charge capture tech-enabled solution, these hospitals were able to lift an average of 2.8% net patient revenue, which amounted to over $1 million in revenue returned. Learn how we were able to accomplish this for them.

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How A Community Hospital Was Able To Get Over 4% Revenue Lift With RCM & Charge Capture Optimization

A hospital client was under significant cash flow pressure and had no available budget to make new resource investments. The hospital’s RCM team had minimal access to real-time data and was burdened with many manual processes. Our holistic assessment identified conservatively a 4.1% net revenue lift potential across many initiatives, including charge capture optimization, strategic pricing, denial management, claim validation, and patient balance after insurance. The assessment also identified numerous “soft value” opportunities to optimize workflows and how their RCM team leveraged their EMR platform capabilities, as well as a new set of data requirements and going forward performance metrics. With our plan execution, the hospital realized improvement in net cash yield was substantially higher than the 4.1% assessment finding. Learn how we helped them realize this revenue.

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More Case Studies

FINANCIAL BENEFITS

Positive Results After Implementation

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2%+

net patient revenue improvement

12-16%

missing outpatient charges discovered

15%

cost-to-charge reduction

98%+

billable events charged

Integrations

Compatible With Most EMRs

We offer bi-directional integration with most EHR/EMR/LIS/RIS with API, HL7, FHIR, X12 or EMR developer programs so that your staff can continue to capture charges while we help prevent missing charges from your local system Here are some of the systems we integrate or are compatible with.

eClincalWorks
Infinx - Partner - athenahealth
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EDUCATION

Helpful Resources For Your Team

We create educational materials frequently in the form of virtual office hours, articles, white papers, webinars and podcast episodes which help our clients and peers with common charge capture challenges they face. If you would like us to address a specific topic, feel free to reach out to us.

WEBINAR

Reduce Missed Reimbursement Opportunities with Effective Charge Capture

Article

Leveraging Technology In Rural Hospitals Minimizes Unrecorded Charges

WEBINAR

How To Uncover Missed Revenue Opportunities In Rural Hospitals

ARTICLE

How Charge Capture Optimization Benefits Rural Hospitals

WEBINAR

How Hospitals Should Approach System Conversions

CASE STUDY

How 3 Hospitals Recovered An Additional $1 Million+ With Charge Capture AI

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Reviews

Our Clients Grow With Us

Happy clients makes it easier for us to help them continue to scale.

Rural hospitals face many challenges, including hiring experienced revenue cycle talent. To be successful, you must either hire experienced talent, provide extensive training, or find an experienced business partner to assure cash is being collected in a timely manner. Jason and his team has surpassed our expectations.

Chief Executive Officer
Rural Hospital

At a time when hospitals face tremendous economic pressures to meet changing regulatory, clinical and consumer demands, they are a tremendous resource providing a no-risk solution that delivers bottom line impact.

Chief Executive Officer
Regional Medical Center

The only certainty in healthcare is revenue cycle is more and more complicated. As pressure mounts, our partnership on a myriad of engagements - all of which have delivered results which exceeded expectations. Value added in action - they are a strong RCM partner to our organization.

Director, Patient Financial Services
Regional Medical Center

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Looking To Capture More Revenue From Services Rendered?

Contact us to learn how our charge capture solution can help ensure accurate billing and increase revenue for your organization.

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