Challenge
A large Midwestern-based health system with 4,000 beds and 3,000 employed physicians had significant gaps in its charge capture reconciliation processes. The organization also needed to enhance its clinical documentation and charging processes to meet ongoing demands for improved financial performance.
Solution
The health system implemented R1 Charge Capture to increase its overall revenue stream. By aligning physician- and hospital-billing functions, the charge capture solution was able to capture missed and miscoded charges across inpatient, outpatient, primary care and specialty settings. R1’s expert auditors and coders provided much-needed support to the health system. They analyzed coding and data to distill accurate, actionable and reimbursable predictions that were ready for the client team to verify, code and bill.
Results
In the first two years, R1 recovered $9 million in revenue for the health system. R1 Charge Capture provided linkage between their professional billing (PB) and hospital billing (HB) functions, resulting in an 80% acceptance rate. Revenue leakage analytics led to systemic process improvements, identified technology gaps and complemented EMR conversion roll-out.
Financial
$9M
recovered in first two years
Operational
80%
acceptance rate
Continuous improvemen
50%
reduction in errors
