Revenue-generating charge capture audit tool
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Healthcare financial leaders face a variety of threats to the revenue cycle. Common challenges include manual processes, the lack of integrated workflows, and different IT systems as well as external challenges, such as regulatory issues and shifting reimbursement regulations. Furthermore, changes in billing methods, new technologies, lack of staff training, and obsolete charging practices force healthcare organizations to leave a portion of net revenue on the table. To address these obstacles, revenue cycle leaders need granular data that reveals the root cause of lost charges. With the Health Catalyst VitalIntegrity™ web-based application, health systems can efficiently manage hospital charge capture processes, detect compliance issues, and secure more earned revenue. By revealing the root cause of every revenue challenge, VitalIntegrity enables teams to minimize leakage from under- and over-charging, late or missing coding, mismatched charges and supplies, and a wide range of CDM-related matters. Adam Ziegel, Director of Product Management, demonstrates how VitalIntegrity can help your organization identify considerably more revenue opportunities.
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Revenue-generating charge capture audit tool
- 1. © 2021 Health Catalyst Amplify Your Organization’s Revenue Opportunities: Introducing VitalIntegrityTM by Health CatalystTM August 2021 – Adam Ziegel, MBA, Director of Product Management
- 2. Agenda © Health Catalyst. Confidential and proprietary. • What is VitalIntegrity? • Why Charge Capture? • VitalIntegrity Use Cases • Client Feedback and Successes • Demo • Charge Capture Expert Services • Vitalware Portfolio Overview • Live Q&A
- 3. © Health Catalyst. Confidential and proprietary. 3 VitalIntegrity Fundamentally, VitalIntegrity™ is a revenue generating, charge capture audit tool that processes Hospital Itemized Bill (or 837 Institutional Claim) data through our proprietary rules engine—then presents accounts with potential issues for review.
- 4. © Health Catalyst. Confidential and proprietary. 4 Key Features • Comprehensive, continuously updated rules engine • Highly adaptable workflow optimization designed to facilitate prioritization and identify root causes • Full transparency into all results • Ability to accept 100% of a health system’s itemized billing data or 837 institutional claims • Expert service team facilitating implementation and available for add- on expert services
- 5. © Health Catalyst. Confidential and proprietary. VitalIntegrity Rule Engine - Example 5
- 6. © Health Catalyst. Confidential and proprietary. 6 Why Charge Capture? HFMA reports that hospitals lose up to 1% of net patient revenue to charge capture issues. Revenue challenges abound: • Manual processes • Never coded, reimbursable charges • CDM issues including outdated or nonexistent codes • Supply/device and procedure mismatches • Documentation errors • Therapeutic dosage errors
- 7. Agenda © Health Catalyst. Confidential and proprietary. • What is VitalIntegrity? • Why Charge Capture? • VitalIntegrity Use Cases • Client Feedback and Successes • Demo • Charge Capture Expert Services • Vitalware Portfolio Overview • Live Q&A
- 8. © Health Catalyst. Confidential and proprietary. 8 VitalIntegrity Use Case: Chief Financial Officer Chief Financial Officer: • Increasing revenue leakage • Rising denials and write-offs • No tool (or an overly costly tool) to monitor charge capture VitalIntegrity can: • Identify issues holistically • Highlight problem areas • Facilitate root cause remediation
- 9. © Health Catalyst. Confidential and proprietary. 9 VitalIntegrity Use Case: Director of Revenue Integrity Director of Revenue Integrity: • Revenue issues in surgery departments • Unable to keep up with rules in self-built and maintained tool VitalIntegrity provides current, expert- maintained rules for hospital billing for all departments allowing users to target high-impact areas as needed
- 10. © Health Catalyst. Confidential and proprietary. 10 VitalIntegrity Use Case: Revenue Cycle Analyst Revenue Integrity Analyst: • Lots of work, little prioritization • Too much time spent investigating low value opportunities • Not sure what I’m even looking for VitalIntegrity provides: • Adaptable workflow management • Rule detail and guidance • Flexible work queue sorting and grouping to aid prioritization
- 11. Agenda © Health Catalyst. Confidential and proprietary. • What is VitalIntegrity? • Why Charge Capture? • VitalIntegrity Use Cases • Client Feedback and Successes • Demo • Charge Capture Expert Services • Vitalware Portfolio Overview • Live Q&A
- 12. © Health Catalyst. Confidential and proprietary. 12
- 13. © Health Catalyst. Confidential and proprietary. 13 Client Feedback and Successes Results: • In a side-by-side comparison with legacy solution, VitalIntegrity found more opportunities • A single error led to recovery of $100,000 and permanent resolution of the error Feedback: • “One coding error can be huge. Being able to monitor with Vitalware gives us a snapshot look at return on investment on a weekly basis. Our savings have far exceeded the cost of the product compared to the errors we're finding.”
- 14. Agenda © Health Catalyst. Confidential and proprietary. • What is VitalIntegrity? • Why Charge Capture? • VitalIntegrity Use Cases • Client Feedback and Successes • Demo • Charge Capture Expert Services • Vitalware Portfolio Overview • Live Q&A
- 15. Agenda © Health Catalyst. Confidential and proprietary. • What is VitalIntegrity? • Why Charge Capture? • VitalIntegrity Use Cases • Client Feedback and Successes • Demo • Charge Capture Expert Services • Vitalware Portfolio Overview • Live Q&A
- 16. © Health Catalyst. Confidential and proprietary. AUGUST 2021 Link to data sheet FINANCIAL ADVISORY SERVICES Key needs addressed • Need for next-step support: Organizations struggle to move from data findings to interventions that truly transform outcomes. • Lack of foundational processes and structures: Systems need reliable ways to diffuse best practices and accelerate improved outcomes. • Limited access to industry-wide lessons learned: Learning from other systems facing similar revenue challenges can accelerate progress. • Inadequate resources: Organizations may lack staff to review batches, summarize financial analytics, audit bills, adapt rules, and manage other activities that make the most of VitalIntegrity insights. Distinguishing features Deep expertise, flexible partnership: An engagement can include one or more types of support in an arrangement that fits your needs: • Side-by-side assistance: Embedding with your team as VitalIntegrity™ “super users”, we help maximize the value of the technology—and boost your organization’s capability for finding, understanding, and prioritizing charge-capture issues. • Guidance for best-practice structures and interventions: Drawing on our understanding of the industry and the successes of peer organizations, we partner with your leaders to identify processes and practices that will allow you to successfully address known gaps and swiftly adapt to regulatory and market changes. • Scalable support: You can access Charge Capture Expert Services in a way that best matches your resources and readiness. Organizations can choose a time-bound engagement or may prefer to have our team members serve as adjuncts to the charge-capture team. Our Charge Capture Expert Services leverage our team’s deep experience in healthcare finance and revenue cycle management to provide an industry- and data-informed approach to understanding and realizing your organization’s best opportunities to improve charge capture and increase revenue. Charge Capture Expert Services
- 17. Agenda © Health Catalyst. Confidential and proprietary. • What is VitalIntegrity? • Why Charge Capture? • VitalIntegrity Use Cases • Client Feedback and Successes • Demo • Charge Capture Expert Services • Vitalware Portfolio Overview • Live Q&A
- 18. © Health Catalyst. Confidential and proprietary. The Vitalware Suite • Focuses on mid-revenue cycle—regulatory compliance, coding, chargemaster management, charge capture, and price transparency • Web-based solutions built on industry- leading content to enhance revenue and improve compliance • Consume and coordinate all your chargemaster data in a single, integrated framework • Operate more transparently, price strategically, and confidently run a compliant and efficient revenue operation. 18
- 19. © Health Catalyst. Confidential and proprietary. Regulatory & Coding Content: VitalKnowledge® Authoritative reference for coding, compliance, and billing Chargemaster Management: VitalCDM® Unified chargemaster management for CDM, pharmacy, physician, supplies, and your other ancillary files Price Transparency: Hospital Price IndexTM Publicly accessible display of standard charges to meet the Pricing Transparency mandate requirements Charge Capture: VitalIntegrityTM Daily charge integrity solution that analyzes 100% of itemized charges for reimbursement and compliance improvement The Vitalware Suite
- 20. © Health Catalyst. Confidential and proprietary. The Vitalware Suite 20
- 21. Agenda © Health Catalyst. Confidential and proprietary. • What is VitalIntegrity? • Why Charge Capture? • VitalIntegrity Use Cases • Client Feedback and Successes • Demo • Charge Capture Expert Services • Vitalware Portfolio Overview • Live Q&A
- 23. The Healthcare Analytics Summit 2021 - Virtual Visit hasummit.com to register and learn more • Industry-Leading Featured Speakers • 21 Educational Breakout Sessions • CME Accreditation for Clinicians • Analytics and AI Showcases, Networking, and More • Virtual Platform optimized for a live experience Sept. 21 – 23, 2021 (half-day sessions) o Steve Kerr o Rana el Kaliouby, PhD o Vin Gupta, MD, MPA, MSc o Chris Chen, MD o Amy Compton-Phillips, MD o Brent C. James, MD, Mstat o Sadiqa Mahmood, DDS, MPH “The virtual experience was beyond any other that I've attended. You all did a wonderful job of creating an "in- person" feel and I appreciate that as a learner. The virtual platform was very intuitive and fun.”