Revenue Integrity

Reduce costs, accelerate payment, and manage audit risk with real-time claim and billing analysis.

Building a Better Revenue Cycle


The Call for Revenue Integrity

The strength of your revenue cycle relies on proper coding, documentation of the clinical care rendered, and compliance. CMS has shown their clear intent to enforce payment integrity in provider billing and 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. What would a 90-99% first time acceptance rate from Payers mean to you?

Our Revenue Integrity Blueprint

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. We have over 30 years of experience helping organizations like yours increase compliance, reduce costs, and speed payments.

We analyze millions of claims and billions of transactions each year in order to maintain and improve our Revenue Integrity platform. Our proprietary system of rules and analytics logic helps speed cash flow and prevent claim denials, and can even reduce audit risk and identify training opportunities so your organization can address recurring issues.


Real-time Revenue Integrity

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Review claims in real-time with the same rules Payers use

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Assess payment compliance at a granular level with advanced Medicare, Commercial and Medicaid analytics logic.

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Manage audit risk and speed reimbursement with audit logic that defines which bills or claims might trigger an audit or require additional documentation.

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Facilitate chargemaster maintenance with pricing that leverages UCR and all 17 Medicare Prospective Payment Systems.

Our Revenue Integrity solution is comprehensive, responsive, low maintenance and cost effective. How is your organization handling the spiralling costs of billing, payment issues, and audits? Contact us to learn more about what Program Integrity can do for you.