Valetude’s RCI Engine drives results in charge capture, coding, and payment variance.
Apply Valetude's proven Enterprise RCI Library of charge capture and coding logic to your data to improve charging practices and boost net revenue. These RCIs can be customized to your facility, or new RCIs can be developed in minutes.
After a specific payment variance problem is identified, the RCI engine will flag each patient and route them to a work queue. This allows your team to efficiently bundle and appeal improperly paid claims in bulk, and to monitor that issues remain fixed on the payer side.
Similar to charge capture, Valetude analyzes various coding irregularities that, when corrected, boost net revenue. These adjustments range from soft coded outpatient procedures to codes that affect DRG complication levels.
A best practice library of revenue generating/cost reduction ideas proven across over 150 hospitals nationwide. Opportunity is continuously evolving as ideas can be shared between various hospital enterprises.
The RCI Engine generates Revenue Cycle Actions (RCAs) which track:
RCAs track and verify actual additional payment transactions, ensuring issues are followed up on and results are as expected.
Performance is tracked by RCI and by follow up person, over time. Results can be evaluated by month over month, department, service location, financial class, or virtually any other available patient characteristic.