Resolutions can optimise hospital revenue

Resolutions has been privileged to help deliver some truly amazing savings and outcomes for our clients’ businesses over the 24 years of our existence. Our clinical coding and auditing services¬†will optimise hospital revenue, streamline business processes and ensure accreditation compliance.

With our customers’ or partners’ consent we’ll showcase some of these achievements and let our clients’ testimonials tell you about them in their own words.

To begin, we’ll open with a small selection of de-identified case studies. We hope these will provide an indication of Resolutions’ expertise in an operational context.

Case study 1

Hospital requests a coding audit to confirm their financial position. A true random sample reflective of their population is conducted. The audit uncovers some coding issues. These are addressed and a further audit conducted in 12 months’ time. In completing the audit, other issues are uncovered, including appropriateness of Type C admissions, and issues with day patients ~ such as dialysis and chemotherapy ~ whose records are kept in the treatment location. Revenue is found under $250,000 but minimised substantially by the next audit.

Case study 2

Hospital requests an audit and a random sample is completed. Although the DRG rate is around the acceptable benchmark with few DRG changes, the financial implications of the few DRG changes is large. Five DRG changes total $350,000.

Case study 3

Hospital management is satisfied its coding is okay based on internal analysis and conduct an audit for education and accreditation purposes. Health funds are satisfied as they track movements, but a review of some specialties reveals that the terminology used in the specialty has been mistakenly identified as something else. The hospital has been gaining for each case without knowledge. The only way to identify these errors is by direct auditing of the medical record.

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