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Revenue Assurance

Heath Information Management & Revenue Integrity Consulting Solutions

 When it comes to the mid-revenue cycle, Guidehouse offers a next-generation, fully integrated approach focused on clinical documentation improvement (CDI) and revenue integrity. 

 

 Revenue Assurance

 

Inpatient and Outpatient CDI
We believe that a properly designed inpatient and outpatient CDI program should result in complete and accurate documentation of a patient’s medical condition.

Our approach:
-Provides an accurate picture of the true acuity and clinical condition of the patient
-Enables coding to the highest level of specificity
-Supports the capture and documentation of all services provided to the patient
-Facilitates quality and continuity of care

Our solution includes:
-CDI: Targeted documentation education; Optimized use of technology smart phrases
-Coding: Analyzes CDI and coding communications and areas of opportunity
-Quality: Analyzes quality opportunities
-Education: Targeted education of diagnosis and provider; Clinical decision support (CDS) education
-A Provider Focus: Provider centric education; Monitoring and reporting documentation score by provider

Revenue Integrity
Revenue integrity is the source of quality assurance within revenue cycle. Our approach integrates revenue cycle, managed care, finance, and clinical to create a global view of gross and net revenue capture. Our solution adheres to the following guiding principles: 

-Provide a central point of communication to system wide revenue generating and supporting departments
-Focus on creating a collaborative mentality across the system when interacting with clinical stakeholders, finance, managed care, and revenue cycle
-Drive standardization and accountability throughout the organization
-Develop shared goal structure and performance metric benchmarks
-Ensure compliant, accurate, and timely charging from the clinical side to ensure reduction of denials and accurate reimbursement 

 

 

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If you are interested in knowing more about Guidehouse and how our expertise can support your toughest challenges during this period, contact our experts.

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