HEALTH SYSTEMS

The strength of your revenue cycle relies on proper coding, documentation of the clinical care rendered, and compliance. Persistent problems in these areas can cost you millions in lost revenue. What would a 90% - 99% first time acceptance rate from Payers mean to you?

Revenue Integrity for Healthcare Systems


CMS has shown their clear intent to enforce payment integrity in Provider billing / claims. EHR's are not experts in this area and their systems have proven ineffective at protecting providers. Poor billing integrity can cost you millions.  Even worse, it increases overhead through the staffing of employees who do nothing but reconcile billing, resolve payment issues and support audits.  With our Revenue Integrity Platform, you can analyze proposed bills to get visibility into problems and actionable insight before the problems leave the business office.

Context’s real-time, cloud based Revenue Integrity Platform provides comprehensive tools including:

  • Review 100% of claims real-time with the same rules Payers use
  • Advanced Medicare, Commercial and Medicaid analytics logic to assess payment compliance at a granular level
  • Audit logic to define which bills / claims might trigger an audit or require additional documentation to manage audit risk and speed reimbursement
  • Pricing leveraging UCR and all 17 Medicare Prospective Payment Systems to facilitate charge master maintenance