Charge Integrity Solutions

Vitalware charge integrity solutions and services help revenue professionals put a stop to revenue leakage from undercharging, and also helps reduce both lost time and revenue from overcharging and denied claims. Our solutions and consulting services enable clients to track errors to their root cause, and quickly gain self-sufficiency.

Vitalware Revenue Integrity Solutions

Revenue professionals know that hospitals leave between 0.5% and 3% of net revenue on the table due to a variety of factors: changes in billing practices; installing new technologies; gaps in staff-training, and charging practices that become obsolete through complacency. If you've been submitting claims with improper charges, it's probably costing you more than you think — and the sooner you take corrective action, the better.

All Vitalware revenue integrity tools leverage a rule set that reaches beyond typical industry charge-integrity tools. Our capabilities apply to both inpatient and outpatient accounts and probe deeper and wider to identify opportunities for improved revenue and compliance. Our clients see more and therefore have the ability to take more accurate and enduring remedial actions. The Vitalware rule-set is also enriched on a continual basis with the most recent coding and billing regulations, so your revenue integrity analysis is always both comprehensive and current.

Two Levels of Response

To fully optimize the value we offer, we help clients meter and strategically deploy their investments by offering two distinct levels of inquiry and response: Assessment and Analysis, and Integrity. Both offerings provide a smooth escalation of information richness and actionable insight, helping clients confidently take next steps, and realize enduring returns as they scale the effort. Our approach is founded on the idea that our clients will want to deploy their time and resources as efficiently as possible.

Know Where You Stand With VitalAssessment and VitalAnalysis

VitalAssessment™

VitalAssessment provides a quick snapshot that identifies charging issues and trends at a high level. This 30,000-foot view lets providers know if they have significant charging issues and guides revenue personnel to areas where further exploration may yield important insights.

VitalAssessment works with a review of a short period of outpatient Medicare claims from the Standard Analytical File (1-3 months) compared against our rules. A Vitalware product specialist reviews the data and creates a client-facing report.

For teams who need fast, broad-spectrum feedback on potential charge and compliance issues, VitalAssessment can provide the diagnostic insight required to determine if further investigation is warranted, and guide that next-level work to optimal results.

VitalAnalysis™

With VitalAssessment providing insight into major areas of opportunity, VitalAnalysis provides a closer look at both charge and compliance opportunities, with processing of outpatient 837i claims against our standard-setting Vitalware rules repository. Results are available for review in a secure user interface, and our team helps get (and keep) you up on the right track by refining and customizing rules to meet your needs. With VitalAnalysis, you can thoroughly analyze the root causes of missed charges, billing errors, and potential compliance issues.

VitalAnalysis offers clients the capability to quickly identify and fully remediate current and chronic sources of lost revenue. Vitalware's rich rule set helps clients take actions that provide enduring value, and can dramatically reduce wasteful rework.

VitalIntegrity: The New Standard In Revenue Integrity Solutions

VitalIntegrity™

VitalIntegrity enables teams to continually assess and minimize revenue leakage from under (and over) charging and facilitates tracking of inaccurate charges — with a powerful analysis tool that enables a comprehensive, daily-transactional review.

VitalIntegrity leverages the power of a dynamic, interactive query engine, which keeps search results consistent. Customized workflows and optimized processes strengthen communication between your revenue cycle and clinical departments, helping you to establish accountability across all key touchpoints, to optimize ROI for all your resources.

VitalIntegrity provides a broad but fine-grained analysis with a retrospective inquiry into your data, in order to positively identify and track significant trends (and their impacts) over time. Through the daily processing of itemized bills (inpatient and outpatient) against the Vitalware Rules Repository, VitalIntegrity provides the richest possible analysis and synthesis.

With these comprehensive results, a Vitalware product specialist offers both a rules QA analysis and recommendations for rules utilization optimization. ROI analysis is offered through daily tracking and reporting, and trend analysis for ROI on recommended actions.

VitalIntegrity brings the advantages of the most comprehensive rule set to bear in a dynamic and responsive reporting environment to optimize revenue integrity quickly and completely and helps clients identify nagging issues and root causes that, once adjusted and properly maintained, bring impressive benefits for both charge-optimization and compliance efforts.

Charge Integrity Consulting

Vitalware Charge Integrity Teams help clients assure they are in compliance with their own internal charging practices, using Medicare charging practices as a default. We'll help you identify corrective actions to promote complete and correct charging as well as compliance. Through our expertise and discipline, our teams can dig deeper to find root causes and patterns to help you learn from past experiences and take preventive actions.

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