OVERVIEW
RevID’s advanced clinical activity routing and charge reconciliation process identified a misclassification of a billable procedure, correcting a systemic EHR charge build issue worth over half a million dollars. This ensured accurate reimbursement for all services rendered, highlighting the critical role of Streamline’s automated solutions in revenue cycle management.
CHALLENGES
- Ineffective Manual Processes: The existing process was largely manual, leading to inefficiencies and errors.
- Lack of Awareness: Unaware of discrepancies in charge builds resulted in gaps during reconciliation.
- Revenue Loss: Missing charges caused significant revenue losses across multiple departments.
GOALS
- Implement Charge Reconciliation Program: Establish a proprietary approach to ensure all services are accurately charged, billed to minimize missed charges and underbilling.
- Pre-bill Issue Resolution: Ensure charge build is accurate, and discrepancies are resolved before billing.
- Expedite Billing: Reduce late billing instances caused by charge build issues, improving cash flow.
OUTCOMES
- Enhanced Charge Reconciliation Process: A comprehensive charge routing audit was implemented, ensuring accurate revenue capture and billing integrity across all service lines.
- Error Identification: Discovered charge build errors, specifically a “No Charge” function was misapplied to a nuclear medicine procedure, preventing automatic charge generation upon completion of clinical activities.
- Significant Revenue Recovery: This single error resulted in reconciliation of gross revenue totaling $568,345.