Dedicated pod teams, concurrent CDI, charge capture auditing, and revenue integrity programs that operate inside your Epic or Cerner environment. Every engagement is governed by six contractual KPIs and a written 90-day exit clause, so the risk sits with us, not your balance sheet.
A hospital revenue cycle fails in the details: a missed MCC, a late charge, an unworked denial bucket. Our delivery model attacks each failure point with a named owner and a measurable target.
Each facility gets a fixed team of certified facility coders, CDI specialists, billing analysts, and AR follow-up staff, led by a named account director. No shared queues, no rotating offshore pools. The same people work your accounts every day and answer for the numbers in your weekly check-in.
Concurrent clinical documentation review, during the stay, not after discharge. Our CDI specialists issue compliant physician queries in real time to capture CCs and MCCs that drive accurate DRG assignment and case mix index, while keeping documentation aligned with quality and risk-adjustment metrics.
Hospitals lose an estimated 1-3% of net revenue to missed charges. Our analysts reconcile clinical documentation against the charge master in OR, cath lab, infusion, radiology, and ED workflows, catching unbilled procedures, implants, and high-cost drugs before they become write-offs.
Multi-layer claim scrubbing plus a denial-pattern feedback loop: every denial is coded by root cause, mapped to the upstream department, and converted into an edit or workflow change. Across our book, clients run a 3.2% denial rate against a contracted ceiling of 5%.
Contract modeling before you sign payer terms, automated underpayment detection against contracted rates, and pre-billing audit standards built to withstand RAC scrutiny. Revenue integrity findings feed a monthly variance report your CFO can take into payer negotiations.
A shared dashboard with 24/7 access, a monthly executive scorecard against all contracted KPIs, and a quarterly business review with our VP of Operations. Metrics are calculated from your data definitions, and your team can audit every number.
We maintain HIPAA compliance through a documented security program covering encrypted data transmission, role-based access controls, audit logging, and annual workforce training. Our information security management system is certified to ISO 27001, with the certificate and statement of applicability available during vendor review. Our infrastructure and controls are additionally validated against the HITRUST CSF, the framework most hospital compliance departments use as their evaluation baseline.
We execute a Business Associate Agreement with every client before any protected health information is exchanged, and we will work from your BAA template or ours, whichever your counsel prefers. We undergo annual third-party penetration testing and provide summary results, along with SLA and breach-notification terms written directly into the service agreement.
Most enterprise RCM contracts run 12-36 months with steep termination fees. Ours starts with a 90-day proving period governed by six contractual KPIs, baselined against your own data during onboarding and scored pass/miss at day 90.
Clean claim rate ≥ 99%, average AR days under 28 (clients average 24), denial rate under 5%, net collection rate at or above your benchmark, response SLAs on provider inquiries, and client satisfaction ≥ 8/10. Each target is documented in the service agreement with your baseline data attached.
At day 90 you receive a formal KPI report card signed by your account director and our VP of Operations: raw data, scoring methodology, and a written attestation. Your finance team can audit every figure against the shared dashboard.
If any KPI is missed, you may activate the exit clause in writing: no termination fee, a 30-day transition runway, full data export in open formats, and vendor handoff support at no charge. You keep all data, reports, and analytics generated during the period.
These results come from a 200-bed community hospital engagement: concurrent CDI lifted case mix index by 0.12 points ($1.4M in DRG reimbursement), an aged AR task force recovered $1.3M from accounts the hospital had effectively abandoned, and charge capture corrections added $420K.
Read the Full Hospital Case Study →A 45-minute working session for hospital and health-system leadership: we walk through your current revenue cycle metrics, where comparable facilities found recoverable revenue, and exactly how the 90-day KPI guarantee would be structured for your organization. No slideware, no obligation.
Prefer to talk now? Call (716) 301-2036 or email info@revenuesynergy.com