ExdionCA – Automated Revenue Integrity Engine
ExdionCA is built on a proprietary rule-based engine that automatically scrubs and flags encounters with possible gaps. Two robust functions – pre-bill code validation and post-bill code audit – deliver financial value to:
- Increase revenue integrity
- Improve provider accuracy
- Standardize care across the practice
- Reduce manual labor and billing errors
- Reduce denials and claim resubmission
- Capture missed charges
- Confirm compliance
ExdionCA Coding Audit Automation Case Study
The client (Ideal Urgent Care) is a locally owned and operated Urgent Care with three locations in Dallas. The
center is rapidly expanding with plans to open two additional centers within the next six months. Each
location season average about 40 patients per day. With the rapid expansion and increase in patient visits,
the center wanted to establish a strong process for compliance and ensure effective revenue management.
ExdionRCM proposed a focused audit and deployed the ExdionCA-UC Coding Automation platform. The
Coding Automation platform is a powerful tool that allows Urgent Care Centers like Ideal Urgent Care to
validate their existing practices, drive provider education and ensure optimal collections.
ExdionCA-UC is built on a proprietary rules engine created by Urgent Care experts. The platform rapidly
skims through large sets of encounters to identify potential issues and helps build necessary control
measures. Urgent Care centers benefit by being able to identify potential billing errors such as:
- Under-billed services
- Over-billed services-frequency
- Denied or Down-coded Services
- Services not billed (missed charges)
Ideal Urgent Care used ExdionCA-UC coding automation on a set of 2000 random charts. A report with the
submitted codes was issued for the 2000 charts, and access to the charts was granted.The findings provided
some deep insights into the documentation and coding practices – money was being left on the table and
potential compliance issues were going unaddressed.
Want to know more? Contact us today for a free trial of the revenue integrity solution developed expressly for acute care centers.