Revenue cycle management remains a challenge for many health systems, with inefficiencies in clinical documentation, coding, and charge capture leading to lost revenue. Building on earlier success using VitalIntegrity, this large integrated health system with more than $4B in annual operating revenue expanded its use of VitalIntegrity to further strengthen charge capture integrity and improve mid-cycle processes. By applying charge capture analytics, refining rules for complex scenarios, and reducing coding delays, the health system minimized revenue leakage and accelerated billing.
The mid-revenue cycle—where clinical documentation, coding, and charge capture intersect—has a direct and substantial impact on an organization’s financial performance. Inefficiencies can lead to missed or late charges, incomplete documentation, and coding errors, which in turn erode net patient service revenue. Nearly 60 percent of hospital chief financial officers identify revenue cycle management, including mid-cycle processes, as one of their top fiscal pressure points. For large health systems, even small revenue cycle inefficiencies can translate into tens of millions of dollars in lost revenue annually.1
This large, integrated health system had implemented VitalIntegrity, improving charge capture accuracy and increasing revenue by millions of dollars annually. Though the health system had already made significant gains using VitalIntegrity, evolving workflows and growing case complexity presented more improvement opportunities.
To address mid-cycle challenges and strengthen charge integrity, the health system expanded its use of the VitalIntegrity application and charge capture analytics. The application enables teams to minimize revenue leakage from under- and over-charging, late or missing coding, mismatched charges and supplies, and a wide range of CDM-related issues while facilitating issue tracking—all the way to the root cause.
By leveraging the platform’s comprehensive rules engine and professional services support, the health system has:
Charge capture specialists continue to receive structured worklists with contextual flags, accelerating the time to reconciliation and timely billing.
In 12 months, VitalIntegrity enabled the health system to achieve an:
“VitalIntegrity has transformed charge capture accuracy across our health system. In just one year, these improvements have yielded nearly $19 million in additional realized revenue.”
- Interim VP Mid Revenue Cycle
The health system will continue to use VitalIntegrity to prevent charge capture errors and optimize revenue cycle performance.
