If you’ve ever been in the position of figuring out why your practice’s revenues are down or needing to defend your hospital stipend payments, you already know what a headache it can be. That’s why, earlier this year, we introduced our newest tool – the Revenue Integrity Audit.
 
Unlike a traditional ACE audit that reviews a random sample of schedule, billing, and medical record data, the Revenue Integrity Audit leverages AI technology to review each and every service provided over the period of a full year.
 
What does that mean for you and your practice?
Backed by a review of the computer-generated output by an expert ACE auditor, we’ll identify the leaks in your Revenue Cycle bucket:

• Services performed but not billed
• Procedures under- or mis-coded
• Errors in billable time
• Data entry issues
• Payor-specific reimbursement issues
•  …and more!

Your final report will provide you with a real-world accounting – in actual dollars and cents – of the money your practice may be leaving on the table, as well as action steps based on the results for how you can plug any leaks discovered throughout the process.
 
How does it work?
Our Project Engineer works with your IT team to compile the schedule, billing, and medical record data from your current system(s), and then our expert Internal Audit team reviews the data and completes the analysis.
 
What do you get in the report?
The report includes your complete schedule, billing, and procedure data in an Excel workbook. This file provides meaningful and easy-to-understand insights into your group’s performance.
 
We’ll begin with a summary page that provides an overview of issues observed for all monthly cases by dollars over-or under-billed and the number of potential exceptions noted. Individual reports on the issues identified dive deeper into each category, with a case-by-case listing of potential issues discovered, as well as direct links to the original medical record and billing data, making it simple to review the data for any individual patient.
 
How will I know it’s working?
One of the most exciting aspects of the Revenue Integrity tool is that it allows us to easily run monthly, quarterly, or annual comparisons of your practice’s data. With our first audit as a baseline, we can easily run new data from your practice from a new time period to ensure that the action plan is being followed and that revenue is improving in a month-over-month, quarter-over-quarter, or year-over-year comparison.