Revenue Discovery

Revenue Discovery and Charge Capture has a significant impact on a facility's revenue. Each department within a hospital that provides goods and services must properly document and record charges to maximize revenue.

Pyramid performs concurrent audits, correcting original itemized bills, and/or retrospective audits, correcting bills after the original bill has been submitted to the payor and paid. Our audit staff corrects undercharging errors as well as overcharging errors.

Charge Capture Compliance Audits - Concurrent and Retrospective Lost Charge Recovery

The value of Charge Capture Audits includes:

  • Utilizing only licensed registered nurse auditors
  • Owning proprietary, state-of-the-art charge compliance software, C-3, which allows the auditor to work at a more productive pace
  • Educating your hospital staff to charge properly
  • Providing detailed reports focusing on problem areas essential to a CQI program

Charge Capture/Protocol Assessment: In many cases, departments do not charge for all the goods and services for which they would receive revenues. This review includes an evaluation of each hospital department's charging protocols to ensure that goods or services are not "given away." Pyramid will focus on consistency of hospital charges, creating formulas to determine patient charges and implementing comprehensive protocols for staff members.

Concurrent I.S. Conversion Program: Pyramid provides conversion protection by verifying that all the patient charges are captured during a system conversion.

Disproportionate Share (DSH) Review and Recapture: Hospital and Medicare/Medicaid filed cost reports can contain incorrect data that directly affects a hospital's DSH payments. We have developed unique, proprietary and comprehensive audit processes to assist in correcting previously filed cost report data that can result in substantial increases in hospital DSH payments.

Additional Revenue Discovery Service Solutions: Pyramid's experienced staff is available to assist in the start-up of your internal audit department. Services include Internal Audit Department Implementation, Software Education and Training and Consulting.