VitalIntegrity Rules delivers proven charge capture logic directly into your environment, enabling teams to identify revenue and compliance opportunities without a new system. 

It provides a review of twelve months of your 837i claims against our set of expert-built rules, with a comprehensive report out on your revenue and compliance issues by service line and rule type. The rules are updated and delivered quarterly, and every six months, you can re-run your 837i claims to ensure charge capture issues are being addressed by the root cause or offending department.  

This approach helps organizations improve charge capture while maintaining current systems, reducing effort, and accelerating time to value. 

How It Works

VitalIntegrity Rules combines proprietary analytics, expert refinement, and ongoing rule delivery to continuously improve charge capture performance. 

• Baseline analysis. Historical 837i claims data is analyzed using Health Catalyst proprietary rules logic to identify missed charges, compliance risks, and department-level opportunities. 
• Rule delivery. Rules are delivered in a structured format that includes rule logic, triggers, targets, patient class, and encounter type. 
• Rule refinement. A designated user can enable or disable rules, refine logic, and mitigate false positives to align with organizational workflows. 
• Continuous updates. Rule sets are updated quarterly to reflect changes in billing practices and new opportunities. 
• Ongoing insight. Concierge reporting provides visibility into performance, trends, and recommended actions to improve charge capture and compliance. 

• Proven charge integrity logic. Expert-built rules identify revenue opportunities and compliance risks.
• Maximize your Epic investment. Enhance Epic with advanced rule logic without adding another system.
• Stay current. Quarterly updates reflect changing billing requirements and regulations.
• Reduce internal burden. Eliminate the need to build and maintain complex rules internally.
• Improve consistency and accuracy. Standardize rules across departments to improve performance.
• Drive targeted improvement. Identify trends, root causes, and opportunities through analysis.

What Is Included 

• Quarterly rule set delivery and claims analysis: Excel‑based rule updates (logic, triggers, targets, patient class, encounter type) with initial and follow‑up 837i analysis using proprietary logic to identify missed revenue, compliance risks, and improvement over time.
• Flexible rule management for licensed users: Refine, enable or disable logic, and mitigate false positives.
• Concierge reporting and expert review: Quarterly reporting package highlighting opportunities, performance trends, and recommended actions, delivered with expert review sessions.
• Ongoing expert support (up to 20 hours per quarter): Assistance with rule review and refinement, performance interpretation, and recommended process improvements.