Revenue Integrity

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It is imperative for today’s healthcare providers to maximize the revenue received for the services they provide. Ineffective internal controls for key revenue cycle processes can affect net revenue by as much as five percent on average annually. Protiviti’s revenue integrity solutions help organizations prepare for payment reform and enhance revenues and margins by improving strategy, processes and system controls. Improvements include charge master accuracy, enhanced charge capture, cash acceleration, reduced denials, identified reimbursement variances, reduced write-offs, increased patient satisfaction, enhanced compliance, and overall optimized revenue cycle performance.

Charge Capture and Charge Description Master

Identify and quantify root causes of inaccurate departmental charging leading to permanent resolution implementation.

Billing and Collections

Process improvement and cash acceleration customized for your organization, including proper monitoring and quality assurance tools.

Denials/Underpayments Management

Analyze and determine root causes; design and implement strategies to minimize denials, and improve operational performance.

Health Information Management

Perform targeted assessments of coding, clinical documentation, provider query, and other processes to identify preventable risk caused by ineffective governance, immature processes, and/or insufficient technology supporting the integrity, accessibility, and efficacy of health information.

Comprehensive Diagnostic and Risk and Control Assessment

Perform an end-to-end revenue cycle analytical and functional assessment to identify net revenue, cash acceleration, and/or process improvement opportunities.

Patient Access Optimization

Redesign and implementation of organizational structure, processes, training, metrics, and reporting consistent with the organization's goals and objectives.