OVERVIEW
Cooper University Health Care needed improved results from their auditing program, better reporting (summary & detail) to assess program’s impact, and a greater ROI and opportunities for long-term improvement.
CHALLENGES
Cooper University Health Care was using an outside firm to handle pre- and post-billing coding audits. The audits lacked the insights Cooper needed to know the program was compliant and reducing revenue leakage as expected.
GOALS
- Create a process for pre- and post-billing reviews
- Prioritize cases for reviews with automated workflows
- Leverage thorough reporting on operational and financial performance
OUTCOMES
Cooper University Health Care realized an immediate impact on operational efficiency and improved financial performance through new revenue capture and compliance risk mitigation. Results include:
- Average of $365 in impact per audited case
- Established and maintained compliance performance metrics
- Ongoing education and improvements
- Total annual ROI of 15.9X
- Strong partnership with Streamline Health, leading to expansion to include Outpatient coding optimization