Revenue Cycle SolutionsPayment Integrity Compass

Don’t Let Revenue Leaks

Drain Your Margins

Payers are tightening reimbursement and passing on the pain of reform to providers, via tougher negotiations and complex contract terms, increased denials, and even underpaying signed contracts. We call this revenue leakage.

The slow loss of contract value seems insignificant at first, but adds up to a major drain on margins. In fact, the average facility loses 5% of its annual revenue to preventable revenue leakage. But best-practice institutions are making million-dollar gains by optimizing contract negotiations, overcoming denials, and recovering underpayments.

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Learn more about reducing revenue leaks and expanding your margins

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Overcoming Denials Recovering Underpayments

Case Study: Key Medical Center*

Key is a 650-bed hospital in the Northeast that experienced lost revenue due to a siloed system, reporting challenges, and poor workflow.

Case Study: Wells Hospital*

Wells is a 300-bed hospital in the Midwest that was unable to quantify an anecdotal underpayment problem.

Results

RECOVERED IN THE FIRST EIGHT MONTHS OF USE

DENIED ACCOUNTS OVERTURNED

$4.1M 324

Actions

Tracking and reporting of all denials in a single comprehensive system

Custom denials report

Auto-generated, prioritized worklists

Actions

Display of true gap between expected and actual payment

Identification of all payment defects and elimination of false positives

Bulk appeals capability to recover high-volume, low-dollar variances

Results

Underpayment Recoveries

RECOVERED YEARLY

$1M+

$1.1MYEAR ONE

$1.8MYEAR FOUR

$1.8MYEAR THREE

$1.5MYEAR TWO

Case Study: Rogers Health*

Rogers is a two-hospital, 800-bed system in the Southwest. Unbeknownst to it, provisions in commercial payer contracts prevented fair reimbursement in outpatient cases.

Optimizing Contract Negotiations

Results

Net Revenue, Large Commercial Payer

INCREASE7.4%$35.0MBEFORE

$37.6MAFTER

Actions

Data-informed negotiation prep

Real-time impact modeling of proposed terms

One-click charge adjustment

* Pseudonymed institution.