Services
Our Services
Discover tailored revenue cycle services designed to meet your organization’s unique needs. Using advanced analytics, AI-driven insights, and deep industry expertise, we provide the tools and guidance to navigating today’s complex reimbursement landscape and achieve your financial goals.
Zero Balance Audit and Underpayment Reviews
- Analysis of accounts with zero balances to identify any missed revenue opportunities post-bill.
- Reassessment of claims to detect underpayments or denials that can be appealed.
- Detailed reporting on findings and potential recoveries.
- Detailed audit of payer contracts to ensure compliance and correct reimbursement rates.
- Negotiation with payers to resolve underpayments.
- Analysis of discharge records to identify incorrect transfer DRG assignments.
- Reclassification of DRG codes to recover additional reimbursement where applicable.
Denial Management
Hospital Billing, Physician Billing, and Reporting
- Comprehensive management of denied claims, including tracking and reporting.
- Root cause analysis to identify patterns and reduce future denials.
- Development of strategies to prevent denials and improve initial claim acceptance rates.
- Identify and address errors before claims are submitted to reduce rework, lower administrative costs, and enable faster appeals for revenue recovery.
- Preparation and submission of appeals for denied or downcoded claims.
- Comprehensive review of clinical documentation to support appeal efforts.
- Follow-up with payers to ensure timely resolution of appeals.
- Using advanced analytics and AI to prioritize high-impact accounts, streamline appeals, and deliver faster, more consistent recoveries with minimal provider disruption.
Revenue Integrity
Using AI and automation to scan encounter data, EMRs, and charge masters for discrepancies—delivering faster, more accurate results than manual reviews.
Bridging the gap between clinical documentation and billing workflows to ensure all eligible services are captured and coded correctly.
Pre-bill Audit: Identify and recover charges that were documented but not billed.
Outpatient CDI: Ensure accurate documentation and charge capture for outpatient services, reducing the risk of downstream denials.
- Inpatient CDI: Use AI-powered analysis to review medical records, align coding with compliant documentation, and support billing with “evidence of” logic to make claims stronger.
Contact Us
Looking to take your organization to the next level? Reach out to Helix Advisory today. Our expert team is here to provide personalized solutions and guide you toward achieving your business goals.