Automated Pre-Bill Data Analysis for Hospital Outpatient Revenue Integrity
As more patient care shifts to outpatient settings, providers are discovering that the unique coding requirements make it much harder to ensure revenue from these services is fully compliant and optimized.
Hospital outpatient coding and payment outcomes are directly linked to CPT/HCPCS codes that are assigned not only by HIM coding professionals, but also by point-of-service charge capture staff. Streamline Health Outpatient eValuator™ analyzes both ‘hard’ and ‘soft’ coded data for each outpatient encounter and identifies those with likely incorrect elements and associated payment outcomes.
By analyzing both hard and soft coded data, eValuator enables your organization to prioritize and address the most impactful issues for outpatient revenue integrity.
Proprietary and custom rules thoroughly analyze each case prior to billing—including hard and soft coding along with relevant supporting materials— to gauge for coding/charge accuracy and compliant revenue capture.
Cloud-based eValuator is easily implemented and maintained. It integrates with existing EHR, encoder and billing systems to minimize disruption and deliver fast ROI.
Flagged charts are returned in real time with detailed recommendations on suspected issues, helping ensure coding and charge accuracy while improving staff performance over the long term.
Using custom thresholds, it gauges and routes flagged cases to the designated resource to ensure your team is always focused on the highest impact opportunities.
Dashboards display real-time KPIs to monitor ongoing performance, while robust reporting offers summaries, including hard and soft coded data, with drill-down capabilities for more actionable insights.
The Outpatient Features You Need
- Automatically scans 100% of outpatient cases, pre billing or post billing
- Reviews hard coded and soft coded elements
- Provides real-time narrative advice on what needs correction and why
- Flexible grading criteria and workflows to optimize impact using existing resources
- Cloud-based and easy integration with existing systems
The Benefits You Deserve
- Cost-effective approach to analyzing outpatient coding and charge data
- Provides narrative feedback for staff development
- Reporting available on coding, code staff, department, facility and enterprise wide
- Confirms compliance and optimizes revenue integrity
- Offers fast ROI while driving sustainable improvements