Revenue Integrity Healthcare

Our Case Studies

We’re Proud of Our Success

We are proud to have helped over 200 hospitals recover lost revenue and optimize their EMR systems—here are just some of our best success stories.

Total Amount Secured

$19.2 Million

One large Southeast Hospital noticed its revenue was millions of dollars less than expected three months following a complete implementation of Oracle Cerner Millennium, including Patient Accounting. Our software was able to instantly identify nearly $4.8 million in lost revenue that other analysts had missed for three months.

Problems

  • Ordered tests were always not being charged
  • Inconsistent charges from one specific location

Tool

  • Panther Charge Integrity Control

Solutions

  • Corrected build and workflow issues in EMR
  • Repaired workflow design issue with charges
  • Identified orderables that never posted charges

Total Amount Secured

$1,500+ Weekly

Midland Health had invested a significant amount into their EHR system but was struggling to find missing revenue and claims that weren’t posting charges. Using Softek’s advanced software solutions, they were able to stop leakage and repair dysfunctional revenue streams

Problems

  • Struggling to find missing revenue
  • Certain claims weren’t posting charges

Tool

  • Panther Charge Capture

Solutions

  • Identified leakage within pharmacy
  • Identified missing EKG charges
  • Repaired charging for blood transfusions

Total Amount Secured

$1 Million

During our engagement at one health system in Florida, we noticed issues with their revenue integrity in healthcare and billing systems related to orders not posting charges consistently. Through the use of our advanced software, we were able to help identify which orderables had missed charges and for which patients.

Problems

  • Inconsistent EMR structure and organization
  • Many payments were being missed or declined

Tool

  • Panther Charge Integrity Control

Solutions

  • Identified inconsistent charging within the Gen Lab
  • Identified mislabeled oderables causing missed charges
  • Confirmed the orderables are now posting to date

Total Amount Secured

Over $240,000

Using Softek’s Formulary Compliance Control, our consultants found 127 QCF build issues that were leading to missed reimbursements at a large western hospital. Our Formulary Compliance Control also identified 2,784 expired NDCs, 366 that were causing Medicare to deny payments, as well as two drugs missing HCPCS codes leading to denials.

Problems

  • No consistent auditing system in place
  • Outdated internal records leading to denied payments

Tool

  • Panther Formulary Compliance Control

Solutions

  • Found 127 QCF build issues
  • Identified two drugs missing HCPCS codes
  • Identified which orderables had missed charges

Request a Demo

With a complimentary demo, we can show you exactly how our Panther technology can help you before you make any commitments.

Total Amount Secured

$2.5 Million

Revenue at one Midwest regional medical center was down six months after going live with Oracle Cerner clinical applications. Using the Charge Integrity Control inside our proprietary Panther technology, Softek’s Revenue Consulting team had instant visibility into charging gaps within each department. With our our unique visibility into the EMR, we identified 10 different orderables with a manual change to the technical tier that had led to missing technical charges.

Problems

  • Leakage was suspected but not identified
  • Some orderables were missing technical charges

Tool

  • Panther Charge Integrity Control

Solutions

  • Identified 10 orderables with manual changes on technical tier
  • Advised client on correcting the system build in its technical tier
  • Assisted client with correcting orderables for the previous 30 days

Total Amount Secured

$3 Million

Revenue at one Southern academic medical center was down six months after going live with Oracle Cerner clinical applications. Softek’s Revenue Consulting team used reports within our Panther Charge Capture technology to quickly locate the source of this six-month-old problem.

Problems

  • Revenue was significantly lower than projected
  • Record management issues caused by poor visibility into EMR

Tool

  • Panther Charge Services Report

Solutions

  • Identified errors in the Pharmacy No-Cost Ingredients Report
  • Advised client on manually correcting costs
  • Assisted client with correction of system build

Total Amount Secured

Over $400,000

The client had a system change that led to inconsistencies in charging. Softek’s Charge Integrity Control compares patient orders and corresponding charges along the entire transaction process. Softek consultants were able to find $270,000 in missed charges within Radiology over a one-day span. Within Gen Lab alone, there was $143,000 in missed charges.

Problems

  • System changes were not synced within EMR
  • No charge audit system in place

Tool

  • Panther Charge Integrity Control

Solutions

  • Compared patient orders to charges
  • Established scheduled system audits
  • Reorganized EMR charge flow

Total Amount Secured

Over $500,000

Using Softek’s Formulary Compliance Control, our consultants found 10 reimbursable drugs with QCF issues in a southeastern hospital. In total, these issues caused over $500,000 of missed reimbursement for the client over the prior six months.

Problems

  • Unidentified QFC issues on reimbursable drugs
  • Consistently missing reimbursement

Tool

  • Panther Formulary Compliance Control

Solutions

  • Reorganized flow of records in EMR
  • Resolved QFC issues
  • Established regular auditing system

What Our Clients Have to Say

Our clients have had great experiences with our Panther technology.

As part of their service, Softek designed a Charge Reconciliation process that is auditable and gives our executives visibility on how each department is doing. Its flexibility allowed Softek to quick…

Anthony Adkins

Director of Application Services, Cabell Huntington Hospital

The only thing I would do differently with Softek would be to engage them on the system build months earlier. I wish I had found Softek earlier.

Chief Financial Officer

Softek has brought more bang for my buck than I ever could have imagined. They deserve every bit of the money. I really couldn't ask Softek to do anything more than they do. In fact, in every way Soft…

Director

Improve Your EHR Performance

Get a quote for our Panther technology, and take your first step to enhancing your EHR experience.