Revenue Integrity

revint_art

From Improvement to Excellence to Innovation

A Proven Approach to Revenue Integrity

The realities of the healthcare market today mean hospitals with erroneous claims face harsh financial and regulatory consequences. And such errors are inevitable given the complexities of patient treatment plans, reimbursement contracts and payer relationships.

UASI’s robust revenue integrity solutions help finance and compliance leaders gain confidence that their claims are clean, their charges are accurate and their bottom lines are as strong as possible.

Revenue Integrity Solutions That Work

Revenue Cycle Reviews

Investigation and audits of billing codes and charges – lost charges, medical necessity audits, Medicare/Medicaid cost outliers, system conversions, OIG audits and more – plus defensive and forensic audits

Reporting

Identifying most common errors in billing codes and charges, trend analysis

Denials Management

Identifying and correcting issues that lead to denials; strategies and tactics for process improvement

What We Do

UASI’s revenue integrity solutions help hospitals perform their best financially by streamlining compliance and enhancing payer relationships.

Focused
  • Designed to meet CMS guidelines
  • Highlighting the most common errors
Comprehensive
  • Denials and Appeals Management – Defensive and Forensic Audits
  • Medical Necessity Audits
  • Medicare/Medicaid Cost Outliers
  • Lost Charge Audits and Recovery Services
  • Clinical Validation Denials/Appeals
  • Pharmacy Audits
  • CARF Audits
  • Forensic Audits/Disallowable Charges
  • System Support Services
  • Readmission Rates
  • Catastrophic Cases
  • Special Projects
  • Rebilling and Collections
  • Credit Balance Claim Processing
  • Corporate Integrity Audits
Technology-Enabled
  • Web-based clinical support tools for accurate assessments of medical necessity
  • Data analytics for targeted samples and trend identification
Flexible
  • Delivered remotely or on site
  • Performed concurrently or retrospectively
  • Tailored to your unique hospital needs
  • Attorney-client privilege
Value-Adding
  • Includes detailed reporting
  • Provides education for your staff
  • Promotes process improvement
  • Supports appeals of claims denials

Real-World Results from a Proven Approach

What kinds of results does UASI’s Revenue Integrity team deliver for our clients?

80-90% Success

Overturn success rate in denials appealed

$4-20 Million

In annual revenue recovered/protected

Improved Relationships

Improved hospital relationships with payers and MAC/RAC

The UASI Difference

UASI’s revenue integrity team doesn’t just follow industry standards and best practices – we establish them.

30plus_years_art

30+ Years Experience

The UASI team averages 30+ years in medical chart auditing

100pct_certified_art

100% Certified

We engage the experts needed for each case – coding, clinical and medical audit specialists, MDs, CMAs, RNs, LPNs, LPTs, RHIA, CCS, CDS, CDIP.

Contact us today to discuss your revenue integrity needs and objectives!