CLINICAL REVENUE INTEGRITY

Prevent downstream challenges upfront

A high quality efficient clinical revenue integrity solution is critical for sustainable financial health of the hospital, health system or physician group.

We can help enhance revenue capture and reduce revenue leakage. Led by our credentialed and certified experts, our tech-enabled solutions help you realize your earned reimbursement and minimize risks.

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CASE STUDY

Health System — 7 hospitals, physician groups, surgery, dialysis & rehabilitation centers

Substantially improve reimbursement accuracy and quality with Conifer’s Clinical Documentation Improvement (CDI) solution

How We Helped:
  • Structured CDI education program, including new-hire orientation and boot camp – monitored progress with quality audits
  • Increased CDI collaboration with Coding and Quality departments, including DRG reconciliation and mortality second-level reviews
  • Improved provider engagement and education, including established physician champions

7%

INCREASE IN MEDICARE CASE MIX INDEX (CMI) CAPTURE

10%

INCREASE IN COMMERCIAL PAYERS CMI CAPTURE

24%

INCREASE IN CDI STAFF PRODUCTIVITY

Accelerate Revenue Capture. Secure Accurate Documentation. Ensure Compliance.

Our Clinical Revenue Integrity solutions serve as a foundation for accurate, compliant documentation and revenue generation. Whether you are looking to improve quality and compliance, build stronger physician relationships, or transform your organization into an innovative leader, we can help.

Manage coding quality and accuracy in changing regulatory requirements

Conifer Health’s Coding & Coding Quality solution delivers exemplary coding in every major specialty leveraging transparent, actionable insights in performance, quality, productivity,and opportunities for process improvements.

Our solution includes:
  • 100% AHIMA or AAPC credentialed coders
  • Inpatient, outpatient, E&M leveling and professional fee services
  • Consistent, unbiased coding quality and compliance program
  • Best-in-class coding education program
  • Advanced anomaly detection, predictive analytics
  • Transparent, accurate data to improve turn-around times (TAT)
  • Flexible staffing model to prevent disruptions in the revenue stream
Prevent revenue leakage with proper charging behaviors

Conifer Health’s Revenue Integrity solution provides you with a comprehensive strategy that ensures compliant, transparent and defensible revenue-generating processes.

Our solution includes:
  • Charge Description Master (CDM) management
  • Charge accuracy audits
  • Late charge management
  • Ongoing education of charging protocols
  • Defensible and transparent price modeling
  • Predictive analytics to prevent missed charges
Ensure complete and detailed documentation

Conifer Health’s Clinical Documentation Improvement solution supports critical reporting for clinical quality and accurate and appropriate reimbursement.

Our solution includes:
  • Operations management and consulting
  • Physician education and engagement
  • Workflow and technology optimization
  • Quality audits and skills assessment
  • Customized physician education and training
Provide essential patient information privacy and security

Conifer Health’s Health Information Management solution focuses on leading the advancement of informatics, data analytics, and information governance while supporting complete, accurate and secure medical information.

Our solution includes:
  • Credentialed RHIT, RHIA HIM consultants
  • Management of the legal health record
  • Diligent eMPI and data integrity management
  • Transcription management and release of information
  • Predictive and prescriptive data analytics
  • Support compliant regulatory requirements
Manage coding quality and accuracy in changing regulatory requirements

Conifer Health’s Coding & Coding Quality solution delivers exemplary coding in every major specialty leveraging transparent, actionable insights in performance, quality, productivity,and opportunities for process improvements.

Our solution includes:
  • 100% AHIMA or AAPC credentialed coders
  • Inpatient, outpatient, E&M leveling and professional fee services
  • Consistent, unbiased coding quality and compliance program
  • Best-in-class coding education program
  • Advanced anomaly detection, predictive analytics
  • Transparent, accurate data to improve turn-around times (TAT)
  • Flexible staffing model to prevent disruptions in the revenue stream
Prevent revenue leakage with proper charging behaviors

Conifer Health’s Revenue Integrity solution provides you with a comprehensive strategy that ensures compliant, transparent and defensible revenue-generating processes.

Our solution includes:
  • Charge Description Master (CDM) management
  • Charge accuracy audits
  • Late charge management
  • Ongoing education of charging protocols
  • Defensible and transparent price modeling
  • Predictive analytics to prevent missed charges
Ensure complete and detailed documentation

Conifer Health’s Clinical Documentation Improvement solution supports critical reporting for clinical quality and accurate and appropriate reimbursement.

Our solution includes:
  • Operations management and consulting
  • Physician education and engagement
  • Workflow and technology optimization
  • Quality audits and skills assessment
  • Customized physician education and training
Provide essential patient information privacy and security

Conifer Health’s Health Information Management solution focuses on leading the advancement of informatics, data analytics, and information governance while supporting complete, accurate and secure medical information.

Our solution includes:
  • Credentialed RHIT, RHIA HIM consultants
  • Management of the legal health record
  • Diligent eMPI and data integrity management
  • Transcription management and release of information
  • Predictive and prescriptive data analytics
  • Support compliant regulatory requirements

Industry Insights and Perspectives

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