CDI and Revenue Integrity: Two Sides of the Same Coin

Clinical Documentation Integrity (CDI) and Revenue Integrity are two sides of the same coin—working together to improve documentation accuracy, prevent denials, ensure compliance, and protect financial stability. This guide shows how aligning these functions strengthens both patient care and revenue outcomes.

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Case Study: Getting Reimbursed for COVID testing of uninsured patients under HRSA program

Amidst the uncertainties of the pandemic, our client, a healthcare provider in Central Florida, had launched Covid-19 testing for both insurers and non-insured patients. Although the client got reimbursed successfully for the insured patients' claims, they were looking for a third-party RCM management company like MBW to help them submit claims electronically under the HRSA program. In this case study, read more about how our team helped collect $60k with a first-pass claim submission rate for Covid testing under the HRSA program.

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Case Study: Improved Revenue Cycle Workflow and reporting functionality accelerates Cash Flow

Most revenue cycle systems have a wealth of unutilized functionality. Revenue cycle professionals need to evaluate workflow and reporting functionality on the revenue cycle system to not only ease their workload but also improve revenue cycle outcomes. Read more in this case study.

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Improving Collections by using the right CPT Codes for Prolonged Service

While the application of prolonged service codes may be fairly simple, very few codes cause more confusion than prolonged service codes. It may be noted that prolonged service codes can be used for outpatient procedures as well as for inpatient care. These codes are typically used to bill for services that significantly exceed the standard time a physician takes while providing care. These may include face-to-face services as well as non-face-to-face services.

While prolonged service coding issues are highlighted in this case study, the principles of educating physicians and clinical staff is applicable for all cases where coding denials are high.

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