Charge capture accuracy is critical to the financial health of every health system. Every year, billing and coding errors result in health systems losing millions in earned revenue. This financial strain can affect operational budgets and limit investments in important patient care services. UC Health was limited in its ability to address charge capture inaccuracies. By switching to the Health Catalyst VitalIntegrity™ application, UC Health was able to address charge capture inaccuracies, identify areas needing improvement, and optimize its processes, resulting in improved charge capture accuracy and efficient billing for all services provided.
UC Health was using a product that managed charge capture processes and ensured payment. However, the product did not meet the organization's needs. Limited reporting impeded the organization's ability to assess and understand improvement opportunities. It couldn’t drill into charge capture issues to determine root causes, and it was challenging to determine net return. The organization needed a new solution to improve charge capture processes and capture more earned revenue.
The solution for UC Health was to implement the VitalIntegrity™ application, a web-based solution that helps health systems improve the hospital charge capture process, capture more earned revenue, decrease A/R days and rebills, and detect and remedy compliance issues. UC Health uses the application to minimize revenue leakage from under and overcharging, late or missing coding, and mismatched charging and supplies. Using the application, the organization identifies issues, generates a worklist for analysts to review, and provides detailed data that enables the organization to track issues and drill into root causes to resolve the problems before the bill for services is submitted.
Analysts use the automated VitalIntegrity work queue daily to investigate and resolve issues. Robust reporting enables the organization to track issues and trends over time and quantify the revenue impact.
UC Health prioritizes opportunities and implements process changes to prevent root causes from occurring again. For example, UC Health identified numerous problems related to missing drug charges. The team easily generated a report to identify the number of missing drug charges, as well as the average dollar amount related to missing drug orders and documentation. Analysts then presented the information to the departments involved, addressed documentation gaps, and changed processes to ensure drug orders and documentation are completed.
The VitalIntegrity application rules engine is continuously updated by experts, and UC Health can customize the application’s rules engine for its unique needs, creating safety guardrails to prevent inadvertent human errors. Leaders routinely review performance reports and engage with Health Catalyst professional services to determine net return and the impact of changes on financial performance. The organization easily identified the top 20 rules with the highest potential for improvement, including service area, case volume, and potential net revenue impact.
Using VitalIntegrity, UC Health has improved charge capture accuracy, enabling the organization to bill for all services provided and increasing net revenue. UC Health has achieved a:
“The VitalIntegrity application gives us the visibility to track real-time issues and address them before they negatively impact our revenue. The automated worklists and robust reporting tools are crucial to driving improvements and ensuring all services are billed appropriately.”
- Chris Resing, Manager Chargemaster Services Manager, UC Health
UC Health will continue to use VitalIntegrity to automate issue identification, address root causes, adjust workflow processes to improve charge capture accuracy, and improve revenue recognition.
