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Enterprise Hospital Billing
Hospital & Health System Billing Services
Hospital billing and collection services built for the mid-cycle problems that drain margins. Documentation gaps, observation status, underpayments. Healthcare revenue cycle management that finds the leaks and stops them.
Revenue Integrity
Comprehensive Hospital Revenue Integrity Services
Our integrated approach combines Clinical Documentation Improvement (CDI) with high-precision institutional billing to capture the full value of every patient encounter.
Enterprise Charge Capture & CDI
We identify missing charges across every department, from surgical suites to outpatient clinics. By integrating Clinical Documentation Improvement (CDI), we ensure that physician notes translate accurately into UB-04 claims, capturing 100% of clinical value.
V28 Risk Adjustment & RAF Optimization
Our experts master the Medicare Advantage V28 HCC model, ensuring your risk scores accurately reflect the true complexity of your patient population while maintaining strict federal compliance.
Predictive Denial Management
We utilize predictive analytics to stop systemic denial management services at the source. Our system identifies payer-specific patterns before they impact your cash flow, allowing for proactive correction of technical and clinical errors.
The Two-Midnight Rule & Status Optimization
We solve the industry’s most litigious billing issue: Observation vs. Inpatient status. Our team ensures strict adherence to the Two-Midnight Rule, protecting your facility from RAC audits and ensuring proper Part A vs. Part B reimbursement.
Contractual Variance & Underpayment Recovery
Our team audits every remittance against specific payer contracts to recover “hidden” underpayments that standard automated scrubbing tools often miss, specifically targeting silent denials in high-dollar procedural claims.
Complex Clinical Appeals & Audit Defense
We handle high-dollar clinical appeals using current medical necessity guidelines. From RAC and MAC audit defense to overturning wrongful denials, we secure your earned revenue through expert-led clinical advocacy.
Interoperability
Strategic EHR Interoperability
Revix MD facilitates seamless, two-way connectivity with enterprise platforms including Epic, Cerner, and Meditech. We provide real-time financial transparency and automated data syncing without disrupting your facility’s vital clinical workflows or patient care standards.
Testimonials
What Healthcare Providers Say
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“Revix MD transformed our mid-cycle. By fixing our documentation gaps and streamlining our CDI process, they recovered $2.4M in previously lost revenue in just six months. Their AI tools for identifying contractual variances are a game-changer.”
Amer Khan
Omali Diagnostic, LLC
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“Their focus on outpatient revenue saved our margin. We saw a 14% increase in procedural collections and a dramatic drop in our days in A/R. They actually understand the nuances of UB-04 institutional billing.”
Jouvonna Gray, NP
Get Well HealthCare Services
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“Their audit protection is unparalleled. We navigated a complex federal review regarding the Two-Midnight Rule with zero findings, thanks to their proactive documentation strategies and expert coding precision.”
Dr. John Codwell
Codwell Family Foot Center
Implementation
A Structured Transition: Your Onboarding Timeline
We understand that hospital RCM transitions are high-stakes. Our 90-day implementation plan ensures zero disruption to revenue.
Phase 1: Day 1-5
Discovery
Full audit of existing A/R, EHR expertise setup, and “Shadow Billing” to identify immediate leaks.
Phase 2: Day 6-10
Expertise Application
CDI team alignment, payer contract loading, and automated workflow deployment.
Phase 3: Day 11-15
Optimization
Full go-live, daily performance monitoring, and first-quarter revenue recovery reporting.
Frequently Asked Questions
How do you handle the Two-Midnight Rule for observation vs. inpatient billing?
We utilize real-time clinical validation to ensure patients are correctly status-coded upon admission. This minimizes the risk of Medicare Part A denials and ensures the facility is compliant with CMS inpatient prospective payment system (IPPS) guidelines.
Do you support CDI program integration?
Yes. We believe revenue integrity starts at the bedside. Our team works with your clinical staff to improve documentation specificity, which is essential for accurate DRG assignment and V28 RAF scoring.
How do you manage RAC and MAC audit responses?
We provide a proactive “Audit Shield.” Our team manages the entire ADR (Additional Development Request) process, preparing clinical packets and legal rationales to defend your claims against the Medicare Recovery Audit Program (RAC) and private payer auditors
Can you support 340B-qualifying hospitals?
Absolutely. We manage the complex modifiers and billing requirements specific to 340B drug pricing programs, ensuring you maintain compliance while capturing essential pharmaceutical savings.
How do you recover silent contractual underpayments?
Our experts manually and digitally audit remittances against your specific payer contracts. We find and reclaim those hidden variances, often related to carved-out procedures or high-cost implants, that basic automated scrubbing tools usually ignore.