Charge Integrity Solutions

Vitalware charge integrity solutions and services help revenue professionals put a stop to revenue leakage from under-charging, and also helps you stay confidently compliant from by not over-charging. Our solutions and consulting services enable clients to track errors to their root cause, and quickly gain self-sufficiency.

The Vitalware Charge Integrity Suite:

A New Standard for Revenue Integrity Solutions

It’s difficult for hospitals to fully capture revenue, while staying confidently compliant, because of the ever-changing codes and rules. That’s why we created VitalIntegrity, a solution that allows you to manage your charge integrity business based on what’s most important to your organization.

VitalAssessment™

When you need fast, broad-spectrum feedback on potential charge and compliance issues, VitalAssessment can provide the diagnostics you need to guide next-steps.

VitalAnalysis™

VitalAnalysis allows clients to quickly identify current and chronic sources of compliance risk that can lead to over or under-charging, presenting data in an easy to use and flexible user interface, so you can create a focused plan to address the charge integrity issues you discover.

VitalIntegrity™

VitalIntegrity provides a dynamic and comprehensive charge analysis, enabling root-cause identification, task assignment, and rules customization in an interface expressly designed to weave all of these functions smoothly together.

A Client-Empowered Approach

To enable our clients to guide their charge integrity efforts optimally, we offer three distinct levels of inquiry: Assessment, Analysis, and Integrity. Each successive level provides a smooth escalation of information richness and actionable insight, so you can take next steps confidently, and realize optimal returns as you scale your effort.

VitalIntegrity™

Your data. Your rules. Your view.

With VitalIntegrity, you’ll improve the hospital charge integrity process, and detect and remedy compliance issues. It will empower your team to recognize inefficiencies and revenue leakage from under-charging, compliance issues from over-charging, and facilitate tracking of inaccurate charges all the way to the root cause.

Our charge integrity solution gives you:

  • An assessment to analyze capture and compliance opportunity
  • Ability for you to customize rules based on charging protocol
  • Review of 100% of your charges daily
  • A view of both missing and over-charges at an itemized bill level
  • Directional net revenue calculation
  • A reconciliation report to understand what's been worked
  • Automated work assignment
  • Support from a dedicated charge capture team

With our new standard of charge integrity, you can process itemized bills or 837s on a daily basis looking for both over and under charges that have gross and net revenue implications. Whether you choose to use it pre-bill, to guide your re-bills, or to fix at the root cause, you have a technology-enabled charge capture solution that is specific to your charging protocol.

VitalAnalysis™

The Daily View

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 our secure, user-friendly interface, with multi-level column sorting, and drag-and-drop grid reorganization. If your results indicate there's significant work to be done, you can transition to VitalIntegrity, and make use of root cause indicators, a flexible workflow, and rules-customization capabilities.

VitalAnalysis allows clients to quickly identify current and chronic sources of compliance risk that can lead to over or under-charging, presenting data in an easy to use and flexible user interface, so you can create a focused plan to address the charge integrity issues you discover.

VitalAssessment™

The Overview

VitalAssessment provides a 30,000-foot view that lets you know if you have significant charging issues, and guides you to areas likely to yield lost revenue. VitalAssessment gives you a report of a short period of outpatient Medicare claims from the Standard Analytical File (1-3 months), compared against the Vitalware rule-set. A Vitalware product specialist reviews the data and provides you with a report of your specific findings.

When you need fast, broad-spectrum feedback on potential charge and compliance issues, VitalAssessment can provide the diagnostics you need to guide next-steps.

More Than Revenue Capture

With VitalIntegrity, we're creating a new standard of quality for mid-revenue cycle tools and services. Just as we did with VitalCDM, we designed VitalIntegrity from the ground-up to re-imagine the problem, the process, and the tools from our clients’ perspective. We're confident that we've developed something that provides lasting value, and makes sense to frontline users, team leads, and executives alike.

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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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Learn more about how our software and services can help your healthcare revenue operation elevate to a new standard for quality and efficiency.

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