Revenue Integrity Services

Revenue leakage is a problem
that still plagues hospitals.
revenue cycle services

Revenue Integrity Experts serving hospitals of every size and region

BESLER offers a suite of services to address common mid-revenue cycle concerns. Whether you have an existing revenue integrity team who wants to recover more revenue – or no revenue integrity team at all – BESLER’s Revenue Integrity Services can help your hospital capture more of the revenue its rightfully earned – and stay compliant.

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Inpatient DRG Validation

Improvements in coding accuracy from 25-60% translating to tens of thousands of dollars hospitals have recovered.
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Transfer DRG Revenue Recovery

Ensure you’re identifying all potential underpayments. Even after another vendor review, our second sweep of the same claims often identifies 30% or more additional revenue.
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Auditing Services

Rapidly identify compliance issues on medical claims for hospitals specifically interested in validating the compliance of their claims. Retrospective audit of technical coding encounters – focusing on specific services lines or procedures of interest.
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Medicare Advantage (MA) Transfer DRG

Provide validation of impacted claims to ensure you’re identifying all potential underpayments for MA plans.
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IME Revenue Recovery

Quickly uncover Medicare Advantage shadow claims meaning more payments, more revenue and fewer headaches.
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Overpayments

Accurately identify and report overpayments to ensure you’re completely compliant with Medicare regulations.
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Charge Capture Review

Track a charge from the medical record to the detailed bill to the final submitted claim to the remittance advice.
  • No costly software implementations.
  • Majority of services are contingency-based, no risk or out-of-pocket costs.
  • Revenue can be realized as soon as 30 days after onboarding.
  • Our Revenue Integrity solutions have a 94.1 rating with KLAS and have earned the coveted “Peer Reviewed by HFMA®” designation.
  • We achieved HITRUST Risk-based, 2-year (r2) Certification.

What is Healthcare Revenue Integrity?

Healthcare revenue integrity includes ensuring compliance, coding accuracy, appropriate charge capture and reasonable pricing for services provided.

Healthcare revenue cycle teams are experts in every component of the billing process, but their primary focus is identifying issues that may delay a bill, resolving those issues and getting the bill sent out as quickly as possible.

This differs from a Revenue Integrity team tasked with educating staff and proactively identifying workflow issues. As the name implies, identifying all facets that could prevent a high level of revenue integrity from being achieved is key.

The highly skilled members of Revenue Integrity teams must understand both the back-end billing process and the front-end billing process. This unique combination of experience gives them the insight to identify and overcome roadblocks to achieving consistent integrity in revenue.

True operational experts – across a health system.  Revenue Integrity professionals no longer spend their entire time at a desk located in a building apart from clinical staff – they now regularly interact with clinicians – building relationships and developing partnerships ensuring efficiency.

Guaranteeing the integrity of revenue is critical in these everchanging times. Healthcare providers are challenged to do more with less while treating a growing number of patients.

Hospital Revenue Integrity Testimonials

Their services have given us a significant net revenue increase.

“BESLER’s cost structure is reasonable. Their services have given us a significant net revenue increase, but that has not been the only outcome. The firm has shown us how to do some things internally. We are not just paying them a fee, and that is what I like most about them. They are not out there just for themselves. They show us what they are doing and how we can do some of those things ourselves.”

Selected commentary collected about BESLER Revenue Integrity/Underpayment Recovery Services September 2022 ©2022 KLAS. Visit klasresearch.com for a complete view.

Partner with BESLER for Proven Solutions.

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