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Delivering Pricing Intelligence, Coding Compliance and CDM Analytics to the Key Stakeholders in Your Hospital
Engage your organization's clinical directors through an automated workflow, continual charge analytics and ready access to peer pricing and other regulatory information tailored to the services performed in your clinical departments. VitalCDM’s robust design and unique user interface is specifically intended to save time and frustration, and facilitate accurate and comprehensive charge generation within all billing systems, including today’s complex billing systems.
High-level executive view of key performance indicators shows trending over previous three imports and analysis.
Provides pricing benchmarking based on your defined peer groups by hospital, department and line item.
Visibility to your CDM data continues to become more complex. Today more hospitals are switching to sophisticated Patient Accounting Systems (PASs) that replace traditional data structures with a more global and interconnected CDM approach. This industry shift in the way PASs - handle service line data obscures the 360 data view, impacting critical visibility to accurately code and bill for the services received by the patient. As a result, this strains healthcare administrative resources, putting compliance and revenue at risk.
VitalView™, a powerful feature available with our VitalCDM™ product suite, eliminates the challenge of limited viewability through a proprietary multi-source 360 view giving complete transparency and connection to all ancillary systems referenced and utilized by your organization.
VitalView solves the challenges presented by the current CDM data - allowing your teams to easily view and pull key data points efficiently, accurately - and most of all - completely.
- Review ALL associated procedure, pharmacy and supply items associated with a charge line, creating 360 visibility and organizational transparency
- User-friendly screens giving the flexibility to view and filter by location, service line, volume, revenue, usage – meeting multiple user needs
- View cost center charge line relationships and comparative pricing data in a single screen
- Combine files from various ancillary systems – like pharmacy or supply item – in a single view for easier analysis of data
- Identify discrepancies in descriptions, charges and other pertinent information with ease
- View charge routers, charge navigators, and/or explosion codes in correlation with the charge line being used to bill
Multi-hospital organizations often maintain disparate billing systems and independent chargemaster files containing inconsistencies with descriptions, revenue codes, HCPCS codes, and pricing. Identifying these variances and providing the ability to maintain a single CDM file that can update the disparate CDM files throughout the organization can save valuable resources and reduce revenue leakage. This add-on module to VitalCDM provides invaluable consolidated process provides consistency and accuracy for long term fiscal health of all the chargemaster files maintained throughout your organization.
- System-wide reporting across multiple hospitals through the management of the corporate standard chargemaster file
- Identify inconsistencies and inaccuracies updating them directly from the Corporate Standard File across your hospital system, optimizing your chargemaster files
- Manage change control processes based on your organization’s user defined form requirements, utilizing your hospital’s internal email system
- Interact with all user-defined workflow functionalities through a smart device
- Track interdepartmental routing, approvals and communication, producing an audit log for processing time at any stage of the workflow process
- Seamlessly send chargemaster changes back into the patient accounting system
Comprehensive chargemaster maintenance relies on departmental involvement. VitalCDM’s easy to use workflow add-on module is vital to the success of maintaining a compliant CDM that includes all reimbursable items and procedures for optimal reimbursement. The ability to track and monitor the process will ensure a timely update process.
- Unlimited number of user defined routing and form creations
- Field based permissions and role based security
- Excel import available
- Split line items to send forward, to a previous work queue, approve, or deny
- Add comments and attachments at a form or line level
- Access and process from a smartphone or mobile device
- User defined reminder system
- Linked to VitalKnowledge™ content
- Detailed workflow analytics determine processing time within work queues and processing time overall
- Export forms to both Excel and PDF
- Place ‘Adds’ and ‘Changes’ to one form
- Add ‘Requests’ to future dates
Pharmacy File Analysis
Ensure appropriate pharmacy medication billing by making sure your CDM and Pharmacy Drug Master (PDM) are in sync. Hospital pharmacy billing is complicated, and these systems typically contain between 2,500 and 4,000 active drug records, while CDM records in traditional billing environments range between 2,500 and 4,000 records.
In addition to maintaining each of these large databases and the interfaces between them, hospitals must also design a routine process for quickly adding new medications. Managing the pharmacy clinical and billing systems is challenging, often resulting in rejections, inaccurate charge information and missed payment opportunities. VitalCDM’s Pharmacy Analysis add-on module assists with this complicated process.
- Analyze pharmacy information using your PDM or CDM if it includes the National Drug Code (NDC)
- Pharmacy Analysis includes:
- NDC validation for billable codes
- Review descriptions using NDC, HCPCS codes and CDM descriptions
- Suggestions for appropriate HCPCS code assignment specific to the NDC
- Pricing analysis using Ambulatory Payment Classifications (APC), Average Sales Price (ASP) and Average Wholesale Price (AWP)
- Suggested revenue code assignment
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VitalCDM is combined with VitalKnowledge™
VitalWare's advanced coding and compliance resource.
VitalKnowledge provides your team with access to meaningful and current information critical to achieving accurate, comprehensive and compliant coding and revenue cycle management and is powered by ICD Sherpa™, VitalWare's patent-pending, proprietary physician documentation engine.
Since 2011, our clinical and coding experts have been linking ICD vocabulary and alias terms with their corresponding medical concepts. ICD Sherpa facilitates organizational continuity by providing consistent search results throughout our suite of documentation, coding and auditing products.