Improving Mid-Revenue Cycle with Precision Auditing Solutions
Driving evaluation, validation, and education to optimize coding compliance
Enhancing the Efficacy of Mid-Revenue Cycle Management
Coding accuracy is the hallmark of a healthy and efficient mid-revenue cycle. At e4health, we implement Mid-Revenue Cycle Management (RCM) solutions with unparalleled quality and experience, delivering valuable financial results.
Our clients benefit from a top-performing mid-revenue cycle, that focuses on audit quality, process improvement, and education. With the increased scrutiny on accurate reporting and optimal reimbursement, coding audits enhance the efficacy of mid-revenue cycle management while ensuring the highest levels of compliance.
Auditing Insight and Expertise
e4health leverages a comprehensive strategy for medical coding audits. Our proven methodologies and results-driven process support a knowledge-based approach and deliver detailed analytics. We pinpoint challenges that undermine healthcare organizations’ medical coding and documentation processes.
As leaders in education, we recognize a platform for exchanging ideas and transferring knowledge, along with a results-driven improvement plan, is pivotal for achieving positive audit outcomes. Our IQ auditing team delivers results and recommendations that are measurable, sustainable, and capable of advancing process improvement goals.
Auditing Solutions
e4health offers full-service auditing support solutions. Our team seamlessly tailors services to meet specific needs, resulting in enhanced operations and an effective mid-revenue cycle. Auditing solutions include:
Clinical coding chart reviews: Inpatient, outpatient surgery, observation, interventional radiology, ancillary, clinics
Emergency department: Academic, trauma level I-V, critical access
Skilled nursing facility, inpatient rehab facility, behavioral health, etc.
Professional fee: All specialties
Coding compliance
MS/APR – DRG validation
Evaluation and management (E&M) validation
Clinical documentation improvement
Data abstracting reviews
Risk adjustment data validation
(RADV)/hierarchical condition coding (HCC)
Charge validation
Due diligence reviews
The e4health Difference for Auditing
Designed to make an impact, our flexible audits meet our client’s unique requirements. Built on an industry-leading approach — combing proven methodologies with best practices, experience, and expertise — we provide quality-driven recommendations optimizing results across the healthcare continuum.
Our audit clients include some of the nation’s largest health systems, academic medical centers, and big four accounting firms, illustrating e4health’s reputation as a leading auditing program provider.
Meet Our Mid-Revenue Cycle Leader
Staci Josten, BSN, RN, CCDS
President, Clinical Revenue Integrity & Operational Excellence
Staci is an experienced Registered Nurse with a bachelor’s degree of science in nursing and CCDS. Staci has an extensive background in healthcare for the past 25 years. She started her career as a bedside nurse in critical care and took care of patients in the pre and post cath lab areas. Staci started her Clinical Documentation Integrity career in 2008 in Des Moines, IA. She was later promoted to CDI Director and later to Regional and National Director of the Health System. Responsibilities included overseeing over 35 CDI programs and 100 CDI Professionals across the United States. In 2015, Staci joined a healthcare staffing and consulting company. During this time, started as manager and promoted to Senior Manager, and then Director. Her responsibilities included overseeing CDI professionals as well as development and implementation of CDI Projects including CDI Assessments and CDI Audits.
Staci is passionate about helping others and enjoys assisting in CDI programs improvements with adequate staffing, ongoing quality reviews, education, and CDI assessments. Staci is a past presenter at state and national for both ACDIS and AHIMA.
Fast-track cash flow. Improve staff efficiency.
Coding Solutions
Immediately measure impact through increased cash flow, diminished backlog and decreased denials.
Auditing Solutions
Conduct audits and deliver targeted education with our domestic full-time experts.
Denials and Appeals Management
Assess denial trends and tap into valuable education to prevent and manage denials. Our team also teaches you defensive strategies to reduce risk and assist with appeal assessment and submission.
CDM Review
Analyze inpatient, outpatient, and clinic charges maintained in the CDM and impacted by CMS with e4health. We review code accuracy and modifier assignments for compliance and conduct price comparisons versus allowable reimbursement levels.
Education and Training
Mid-Revenue cycle, medical coding, and CDI education and training that maximizes professional performance and optimize outcomes.
CDI Solutions
Capture documentation specificity and maximize efficiency with a consultative approach.
Risk Adjustment and HCC Solutions
Get risk scoring right while remaining compliant with our assessments and education.
DNFB Optimization
Master DNFB cases where bills remain incomplete due to coding and documentation gaps. Discover e4health’s education and continuous improvement programs for healthier bottom lines.
Mid-Revenue Cycle Blueprint
Our mid-revenue cycle lean blueprint workshop is a one-day exercise that will help your organization gain alignment around a mid-revenue cycle strategy and future state path that saves time and money.
Coding Integrity Software Solutions
Access detailed analysis and customizable reporting for any audit type and quickly analyze productivity and reimbursement.