Background

The problem

Revenue cycle professionals need access to a seemingly endless list of public and proprietary content data sources, policies, bulletins, and regulatory guidance to effectively do their jobs. Unfortunately, the list is not only long but also difficult to find and ever-changing, with daily content updates and changes to the location where the content lives (e.g., due to changes to the CMS website). Getting the information they need can also require expensive subscriptions, and even if they can find the right sources and access the latest information, revenue cycle professionals may need expert guidance to help understand the complex content.

In addition, revenue cycle professionals may struggle to identify common coding risk areas occurring at their hospital or health system. Coders and other staff may be regularly missing codes or have trouble selecting correct modifiers, both of which are necessary to preventing costly denials. To prevent these problems or address them if they occur, revenue cycle staff members need to be able to validate claims against medical necessity and other edits and group MS-DRGs, APR-DRGs, APCs, and EAPGs to prevent denials and help ensure they are both compliant and receiving the full reimbursement they're entitled to.

Our approach

The VitalKnowledge® application sets the standard for complete, timely, and accurate coding and regulatory information, all viewable through its easy-to-use and customizable interface. A comprehensive reference tool, it provides quick access to the latest coding, billing, and other regulatory data. Additionally, it contains an industry-leading code validation tool, and with the most detailed but easy-to-understand explanations, it empowers revenue cycle leaders to manage information across multiple facilities. The VitalKnowledge applications provide the info revenue cycle leaders need in the most reliable, comprehensive, timely, and accurate regulatory information solution on the market.

VitalKnowledge sets the standard for complete, timely, and accurate coding and regulatory information, all viewable through its easy-to-use and customizable interface.

Benefits and features

• Manage information across multiple facilities. Maintaining consistency with your CDM across multiple facilities can be a daunting task. With multiple data sources, policies, bulletins, regulations, and news articles available — and with rules changing daily — ensuring access to seamlessly updated information across all your facilities is a must.

• View benchmarking and peer comparisons. With growing price transparency legislation, fast and accurate peer comparison is essential. Using the VitalKnowledge application, your organization can quickly gather and analyze financial pricing information, based on defined peer hospital groups for CPT/HCPCS codes or through professional specialty peer pricing.

• Access web-based knowledge on demand. The VitalKnowledge application provides real-time, single-screen access to information orchestrated from over 100 reference libraries. This content is rigorously updated by our team of content professionals, so your team can focus on billing and rest assured that the information they're working with is accurate and compliant.