An analytics solution that supports any revenue, audit, and process improvement.
Healthcare Revenue Management Analytics
CentraMed’s Revenue Management Analytics is a cloud-based reporting and analytics solution that supports any revenue audit, review or process improvement activity to improve internal processes and prevent revenue leakages
CentraMed’s Revenue Management Analytics provides best-in-class business intelligence with a focus on the most significant revenue improvement opportunities in all revenue management initiatives. With a patient-centric approach, Revenue Management Analytics expands from individual patient account level detail to illustrate potential enterprise-wide impact on revenue. It also generates and prioritizes work queues with maximum revenue improvement opportunities, on a real time basis. From RAC audits to 3rd party Defense audits, from payment variance reviews to charge, coding and CDI documentation reviews, Revenue Management Analytics provides for the tracking and trending of transactional and process correction – thereby assisting in the prioritization of findings and prevention of further/future revenue leakages.
Detailed Solution Overview:
Revenue Management Analytics contains several modules that allow the user to import all patient relevant data on pre-determined claim types and populations – thus creating daily work queues and priorities by review type.
- Charge Audit: This concurrent Charge Audit module supports concurrent, defense, and special audit charge capture audit results. Special queries are setup to generate automated work queues based on the business need. All itemized audit results are posted to the patient account and kept in the data repository for tracking and further analyses.
- Managed Care: This retroactive payment variance module contains audit results for managed care, commercial and denials management payment discrepancy reviews. Special queries are setup to generate automated work queues based on the business need. Underpayments are kept in their own A/R system and cash collections are tracked and posted daily.
- CCDR (Coding Compliance & Documentation Review): This module allows for retroactive specialized, targeted audits for high risk CMS documentation and coding errors that often result in underpayments.
- Trend Tracker: This module transforms process improvement observations into quantified process improvement initiatives by reconciling revenue and usage data with transactional results – and providing overall revenue impacts by initiative. The process used is Joint Commission compliant for systemic and error correction activities.
- RACovery ToolKit TM: This module supports Providers response to Medicare Fee for Service (FFS) Recovery Audit Program. Providers can rely on RACovery Toolkit to defend their claims against RAC audits. This web based application is work flow driven, supports in/out patient, rehab, skilled-nursing facility and all government audits. Providers can track from a RAC Demand Letter all the way to Providers’ response to RAC. The application has a robust library of pre-built dashboards, reports, and also supports adhoc report generation. The solution is one of the few certified by Executive Health Resources (E.H.R.), an Optum Company.
- RM Analytics: Leveraging a comprehensive remit and audit national database compiled over the last 15 years, RM Analytics provides metrics driven dashboards and reports that allow providers to bench-mark with similar size systems, regional state and national levels geographical regions, etc. Users can leverage pre-built dashboards with KPIs and have the flexibility to create adhoc dashboards, and multi-source reports. The mobile friendly platform is user friendly with simple drag and drop functions, benchmarks and alerts.
Revenue Management Analytics provides one of the most comprehensive audit and analytics solutions available today. Whether you have an internal or vendor-based Revenue Integrity Department or outsource audit services, Revenue Management Analytics ensures a solution that converts data into actionable information for correction and overall process improvement.