Mid-Revenue Cycle
The mid-cycle bridge connects clinical outcomes with financial sustainability through several key functions
- Clinical Documentation Integrity (CDI): Ensuring medical records accurately reflect the patient’s severity of illness and the care provided.
- Charge Capture: Systematically recording every billable procedure, medication, and supply used during treatment to prevent missed revenue.
- Medical Coding: Translating complex clinical narratives into standardized ICD-10/11 and CPT codes for insurance claims.
- Revenue Integrity & Auditing: Reconciling clinical and financial data to identify discrepancies and ensure compliance with CMS and other regulatory standards.
- Utilization Review: Verifying medical necessity to align with payer requirements and secure coverage for treatments.
- Seamless Patient Enrollment
We manage the complete intake process to ensure patients get started on their prescribed therapy without delay. Our team proactively identifies Financial Assistance Programs to eliminate cost as a barrier to care.
- Comprehensive Benefit Verification
Our experts leverage advanced Real-Time Benefit Verification (RTBV) technology to capture a 360-degree view of coverage, including primary, secondary, and tertiary insurance.
- Expert Prior Authorization Management
We take the “paperwork” off your plate. Our team identifies prior authorization (PA) requirements immediately and coordinates with all stakeholders to secure rapid approval.
