HRAA is known nationally for its expertise in coding, auditing and revenue integrity services.  Since our inception in 2001, we have specialized in building reimbursement proficiency by focusing on the entire revenue cycle, not just coding, and by providing RAC oriented audits, education and consulting services.  Because our approach is to focus on the client’s needs and develop the solution on an individual basis, our team possesses extensive experience in revenue cycle issues.  We focus not merely on the revenue and codes, but on their operational uses. HRAA’s consulting services provide secure and effective solutions for complex regulatory challenges, internal inefficiencies and revenue cycle analysis. These services include:

Pricing Strategy

HRAA evaluates existing pricing structures for the purpose of recommending a tiered or acuity-based pricing structure.  In formulating these recommendations, our work effort includes numerous steps including various evaluations and assessments of current activity. We combine the use of powerful software applications with seasoned healthcare professionals to tailor the project scope and output to ensure your objectives are met.

Documentation Analysis

HRAA applies proven investigative techniques to the review of medical records.  HRAA is trained to assess all components of the medical record to include discharge summary, operative report, physician notes, anesthesia record, history and physical, consultant notes, and other entries. 

RAC Vulnerability Reviews and Appeals

HRAA professionals have worked with healthcare providers and attorneys nationwide on appeals and audits from a wide variety of private and regulatory agencies. We have worked on complex projects with law firms that require we maintain attorney-client privilege, establish codified work-product relationships and develop winning methodology for successful Medicare appeals.  In other instances we have completed audits to determine a providers risk for revenue recapture and develop a plan for reducing their exposure through improved processes and staff education.  We bring you the best, most experienced and most cost-effective solutions for limiting your RAC recoopments and overturning denials.

Charge Description Master Services

HRAA will ensure that your charge master is complete, compliant and current.  Additionally, we will identify revenue opportunities associated with the charge master from the errant components of the charge master to associated operational issues that, when rectified, potentially lead to revenue enhancement opportunities. We review the CDM against clinical documentation and claims data to identify opportunities to amend processes that detract from complete, compliant and current billing practices.

Outpatient Revenue Cycle Operations

HRAA will conduct an outpatient revenue integrity assessment wherein HRAA will assess the HIM facility’s outpatient coding function in order to identify the facility’s entitled and legitimate outpatient revenue based on accurate coding, reliable transfer of data, complete documentation and secured reimbursement.

Healthcare Fraud/Defense Litigation Support

Providers nationwide retain HRAA to work with their corporate or external counsel on a monthly basis or on a project-by-project basis.  Our staff is highly experienced and our knowledge and application of Medicare rules and regulations is unparalleled in the industry.  We know coding, compliance, billing, collection and we know it from the perspective of the provider, payor and patient. From our coders to our nurses, from our compliance research team to our healthcare financial team, we are your support team for all your fraud/defense support needs.