Background

The problem

Hospitals are under constant pressure to reduce denials and the number of A/R days, while optimizing cost and efficiency. This is complicated by inherent obstacles, such as manual processes, the lack of integrated workflows, and different IT systems. External challenges like regulatory issues and shifting reimbursement methodology make it difficult to generate revenue. This all results in charges getting missed, errors in coding, and overcharges, which not only have a negative impact on hospital revenue but also create budgeting and utilization challenges, patient satisfaction issues, and significant compliance risks.

Revenue professionals know that hospitals leave a portion of net revenue on the table due to a variety of factors, such as changes in billing practices, installing new technologies, staff training (or lack thereof), and charging practices that become obsolete through complacency. By addressing these obstacles, hospitals can become more efficient, more productive, and gain insights from data to drive standardization and reduce costs.

Our approach

The Vitallntegrity™ application is a web-based application that enables hospital systems to improve the hospital charge-capture process, capture more earned revenue, decrease A/R days and rebills, and detect and remedy compliance issues.

It enables teams to minimize revenue leakage from under- (and over-) charging, late or missing coding, mismatched charges and supplies, and a wide range of CDM-related issues, while facilitating issue tracking—all the way to the root cause.

This focus on root cause stems from our commitment to providing rule and data transparency and enabling self-sufficiency by leveraging the power of tailored workflows, flexible reporting, and analytics in a dynamic, interactive query engine.

Benefits and features

  • Save time with fast analysis results. Perform daily reviews of 100% of your inpatient- and outpatient itemized charges or 837 files. VitalIntegrity provides a full view of soft-coded, hard-coded, diagnosis, and root-cause information.

  • Identify systemic issues and close financial gaps. Analyze your capture and compliance opportunities, including missed charges and over-charges.

  • Identify a wide variety of hospital-based charge capture issues. Our comprehensive rules engine is continuously updated by experts.

  • Customize rules based on your charging protocol. Our adaptable solution can be optimized to identify gaps and root causes.

  • Increase efficiency and productivity. Automate work assignments for your analysts or team with easy-to-use, pain-free maintenance. The account level view allows you to address all charge capture issues at once.

  • Optimize implementation. Partner with our consultants for retrospective analysis, initial rule refinement, and workflow routing to ensure successful implementation.

The VitalIntegrity account detail view highlights data that triggered an account for review.