RM Validate

MS-DRG Pre-billing Risk Analysis

Uncover Coding Compliance and Revenue Integrity

RMValidate is a cost-effective cloud-based application to assist healthcare providers in detecting missed revenue opportunities, potential coding compliance errors, and reduce costs of incorrect original billing. RMValidate intelligently analyses pre-billed MS-DRG based on predetermined qualifiers, automatically flags claims that have a likelihood of MS-DRG validity, either missed revenue integrity opportunities or potential coding compliance concerns, and provides a narrative description that guides coders on the reason the claim was flagged. By addressing root causes behind your coding challenges, RMValidate can improve billing practices, pinpoint educational opportunities for coders and clinical documentation improvement specialists, and accurately reflect patients’ clinical complexity. Inpatient coding is one of the biggest and most important areas when it come to a hospital’s coding compliance policy!

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Benefits

Cost-effective approach to analyzing and validating MS-DRG coding, pre-billing and post-billing.

Promotes coding accuracy and confirms compliance to drive revenue integrity and mitigate financial risk.

Flag claims to uncover missed documentation, coding, and query opportunities.

Accurately capture MCC, CC and identify trends in documentation.

 
 
 

 

Capture overlooked opportunities for application of coding guidelines.

Address root causes behind your coding challenges.

Reduces denials and associated costs for claims rework, audits and appeals.

Automate Underpayments and Denial Capture

Revenue Master also offers Underpayment and Denial Recovery Services to automates and simplify underpayments and denial capture for all payers. We include recommendations of best practices for process improvement. The performance management dashboard enables reporting on remittances, denials and outcomes, allowing complete transparency and visibility to work activity and results.

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Download Revenue Masters CvC — our mobile app for iOS and Android.

Use CvC (Collected vs. Collectable) to monitor your team’s payer collections progress and see all of your quick charts 24/7. Monitor payer collection performance with an eye towards achieving 100 percent payer collectability.

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