Dedicated pod teams, concurrent CDI, charge capture auditing, and revenue integrity programs that operate inside your Epic or Cerner environment. Every engagement is measured against six performance standards, baselined to your own data, and scored on a monthly executive scorecard your finance team can audit.
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 our internal 5% ceiling.
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 clearly defined SLA and breach-notification timelines.
Most enterprise RCM vendors describe performance in pitch decks. Every Revenue Synergy engagement is measured against six performance standards, baselined against your own data during onboarding, scored at a formal day-90 report card, and tracked on a monthly executive scorecard from there.
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 calibrated to your own baseline data during onboarding and tracked on a monthly scorecard you can review.
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.
A missed KPI triggers a documented corrective action plan: root-cause analysis within 5 business days, a named remediation owner, and weekly reviews until the metric is back on target. An independent quality assurance team audits production work against a 98.5% coding accuracy standard.
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 six performance standards would be structured for your organization. No slideware, no obligation.
Prefer to talk now? Call (716) 301-2036 or email info@revenuesynergy.com