We Provide Two Services Depending on Your Need.

Auditing and Analytics Services

Automated Dashboard Services

  • Clinical Documentation Improvement Audit
  • E&M Utlilization Review
  • Underpayment Analysis
  • Reimbursement Trend Analysis
  • Contractual Variances
  • Billing Guidance
  • Coding Guidance
  • Training and Education
  • Data Visualization
  • Automation
  • Training
  • Subscriptions
  • Notifications
  • Alerts
  • Reporting


Providers Should not be Reimbursed at a Lower than Contractually Allowed Rate

“According to the United States Department of Health and Human Services (HHS), for every dollar spent on healthcare-related fraud and abuse investigations, the government recovers $7.90. In 2016, the healthcare fraud prevention and enforcement efforts recovered $3.3 billion” (Source AAPC CPMA Course).

Every year billions of dollars are recouped by government and commercial plans due to provider’s coding and billing inaccuracy. Two significant reasons for audits are improper coding (code submitted does not match the services, billing twice for services) and exaggerated coding (billed higher service level than provided). In addition to keeping up with the coding and billing guidelines, it is also imperative to audit the medical records to ensure proper documentation, accuracy and prevent recoupments. Many providers only focus on providing training to their staff; however,they may overlook the importance of regular audits. 

Also, Payor audits and recoupments are other areas that make revenue forecasting challenging. Our medical records and claims auditing expertise will help your organization be proactive instead of reactive to the payor audits. 

The team at Revenue CycleBi has hands-on experience with coding and billing in different healthcare areas, including labs, physician’s office, outpatient and inpatient centers. Coding and Billing is the part of the revenue cycle that needs the most attention from the reimbursement perspective. Coding and Billing guidelines often change and can sometimes vary by payor and state. Also, our teams have shown their commitment and interest in coding and billing by obtaining several certifications from AAPC. 

Early on, our team will focus on identifying the revenue leakage in coding and billing. Our recommendations, when implemented, will restore the lost revenue and help your company stay financially healthy.


Data Story Telling and Discovering Hidden Revenue Is Easier With Data Visualization

Regardless of the industry, every business has a finance team tasked to study the historical trends, understand the industry changes, and forecast the revenue as accurately as possible. However, we all know that the healthcare industry is unique in its historical trends and the fast pace of how things change over time. This uniqueness is even more relevant within our industry's revenue cycle due to new payor guidelines, local and federal regulations, and technology changes. Therefore, accuracy with forecasting becomes challenging. Revenue Cycle BI is a small start up dedicated to helping you and your business find opportunities within the revenue cycle. We want to utilize and train your revenue cycle team on different business intelligence tools and other technology to help identify those opportunities for improvement. 

Starting with the early phase of pre-registration in revenue cycle to the denial management phase, each step produces data that could impact both patient experience and payor reimbursement. There are opportunities in each phase to present the data visually in a way that makes the decision-making process easier for the leadership team. Our team has expertise in several different kinds of data visualization tools and can help build KPI dashboards for your revenue cycle team.

Below are four examples of the dashboards with actual data. The three snapshots in the slides format are not interactive,however, the bottom one for E&M Utlization dashoard is built on POWER BI and is fully interactive. 

Revenue Cycle Bi

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