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Revenue Integrity/Underpayment Services 2022
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Revenue Integrity/Underpayment Services 2021
Do Deeper Engagements Lead to Better Outcomes?

author - Boyd Stewart
Boyd Stewart
author - Alex McIntosh
Alex McIntosh
April 1, 2021 | Read Time: 8  minutes

Vendors that offer revenue integrity/underpayment services help clients receive owed reimbursements and fix internal processes that inadvertently create inefficiencies or lower payments. Measured vendors perform very well overall. They tend to partner closely with clients and are often paid on a contingency basis, which highly incentivizes them to find every last dollar. KLAS’ 2019 report on this market examined differences in experience and partnership with these vendors. This report builds on that research and compares the experience of vendors’ deepest-adopting clients (i.e., clients using their vendor’s services across several areas of revenue integrity) with the experience of standard clients to assess how deep adoption affects the overall client experience. 

What Is a Deep Adopter?

For this research, KLAS asked measured vendors to share a list of their deepest-adopting clients—i.e., those using a vendor’s services across multiple areas of revenue integrity. Interviewed clients from those lists are called “deep adopters” in this study. All other interviewed clients are referred to as “standard clients.”

besler performance metrics

BESLER Delivers High Value for Deep Adopters; Strong Partnership Less Likely for Standard Clients

BESLER’s standard clients and deep adopters both report very high levels of satisfaction. The smaller sample of deep adopters regularly refer to BESLER as a partner. They report having a direct line of communication with BESLER executives and feel the vendor is invested in their success, even if that means BESLER ultimately loses additional money. All deep adopters say their expectations are consistently exceeded due to the vendor’s collaborative approach to finding opportunities for increased collections. In contrast, two-thirds of standard clients report exceeded expectations; respondents cite some minor misses regarding timely communication and a lackluster partnership. Across standard and deep-adopter clients, the vendor is seen as having reasonable pricing, including contingency-based costs that ensure clients know how much they will be charged each month. This, combined with the additional revenue BESLER has delivered for clients, leads to very high ratings among all respondents for overall value.

“In terms of how well BESLER drives tangible outcomes, they really do pursue the recoveries and are pretty careful. I think they really know what they are doing. BESLER is valuable to us because they are able to bring in additional dollars on homecare transfers that we may not have seen. BESLER finds a lot of skilled nursing facility items, and they are very aggressive as they look for certain things, but they double-check with us first.” —Director of reimbursements

cloudmed revint performance metrics

Deep Adopters Feel Past Revint (now Cloudmed) Acquisitions More Deeply

Unlike other vendors, Revint—renamed Cloudmed after their October 2020 merger with Triage Consulting Group—receives slightly higher ratings from standard clients than from deep adopters. Overall, clients are pleased with the vendor’s ability to execute successfully and bring in revenue as soon as their services are live. Clients also highlight the vendor’s AI software capabilities, which have helped find additional revenue and plug process holes that create inefficiencies. Much of the gap between standard clients and deep adopters is related to past acquisitions by Revint. Deep adopters have seen some declining quality from the people they work with at Cloudmed (Revint), and several say improved staff quality would increase their overall satisfaction. The other metrics with the largest rating disparities between deep adopters and standard clients are tangible outcomes and nickel-and-diming; regarding the latter, respondents report having to negotiate to get their fees lowered to a more reasonable level. While some standard clients comment on the acquisitions, they do not report any relationship changes that have affected their view of the vendor. As the merger with Triage Consulting Group is new, it is too early to determine any potential effects on Cloudmed (Revint) clients.

“The whole design of Revint’s tools is to drive tangible outcomes because Revint only makes money if we make money. They employ coders to really dig into things, and they look for coders who are educated and have experience. I am not saying we agree 100% with everything that Revint has given to us, but we agree with the majority. If we don’t agree, the disagreements are what perpetuate conversations where both sides can say why we each think something should be charged or coded in a certain way. Those conversations provide education on both sides.” —Revenue cycle manager

cloudmed triage consulting group performance metrics

Cloudmed (Triage) Maintains Tight Partnerships amid Merger

Most clients using Triage Consulting Group, now Cloudmed following their recent merger with Revint, leverage the vendor for underpayment recovery. All interviewed clients say the vendor consistently exceeds their expectations and delivers very high value by focusing efforts and expertise on the revenue cycle areas where they perform best. Among measured revenue integrity vendors, Cloudmed (Triage) is the only one that maintains the same high quality of service, execution, and relationship for standard clients versus deep adopters. Several respondents say the merger with Revint hasn’t impacted the relationship or quality of work, and they hope their experience remains the same moving forward. Clients are extremely satisfied with the partnership and services Cloudmed (Triage) provides. The vendor is described as having a high degree of integrity and has realized a significant ROI for clients. Another benefit is their skill in identifying specific issues with internal processes and external payers and reporting those back to clients to help increase accuracy of claims, efficiency, and financial results.

“Cloudmed’s findings yield returns for us. We have received a good ROI. The vendor’s strength has definitely been in the coding area. The vendor is able to provide a very in-depth review. They present information in a clear, concise manner, and there is no question about what our takeaway is. The vendor educates us. They have been able to point out certain things that we weren’t doing correctly, and we have been able to make those corrections. We want to be able to find errors ourselves, but the vendor continues to find new things. We like partnering with the vendor.” —Director of revenue cycle

revecore performance metrics

Revecore’s Flexibility Sets Them Apart

Revecore deep adopters feel the vendor goes out of their way to customize whatever is needed to make the vendor an extension of the client’s own business office; this flexibility is a primary driver of Revecore’s ability to consistently exceed expectations. Standard and deep-adopter clients speak highly of Revecore’s on-site trainings for helping clients improve internal processes and ensure revenue is collected on the first pass, increasing efficiency. A few standard clients mention inconsistent quality of communication with Revecore staff, though this does not impact relationship scores; no deep adopters mention this issue. Nearly all respondents feel the vendor has been very successful in driving tangible outcomes (e.g., ROI) and speak very highly of the staff’s professionalism and the tools and skills they leverage to collect underpayments or other owed revenue.

“Revecore has been absolutely wonderful to work with over the years. Obviously, we could always look for a different partner, but I don’t want a different partner. Revecore works the way we want them to work. They pretty much customize anything we need them to. We are truly partners with them, and they are truly an extension of our revenue integrity and patient financial services. Revecore comes on-site and provides training for registration. They provide a service that we currently cannot do in-house ourselves. We are really relying on them quite a bit until we can get our act together internally. Revecore gives us great feedback pertaining to things that we are doing wrong and things that we can improve up front. They give us opportunities to improve our workflow so that we don’t have to send them so much work to do.” —Revenue cycle director

transunion healthcare performance metrics

TransUnion Brings Industry Experience; More Transactional Than Some Would Like

TransUnion Healthcare and their software (used by interviewed clients in conjunction with their services) have helped clients fill process holes, leading to tangible effects on the bottom line, including being able to reduce or reassign FTEs. Clients appreciate TransUnion’s maturity in the revenue cycle industry. Deep adopters are more satisfied with their relationship with the vendor compared to standard clients. While not dissatisfied, standard clients would like to see TransUnion bring more innovation to the table and work to create a tighter partnership with client organizations. Today, these clients feel their relationship is more transactional, and some say communication has declined recently. Additionally, some standard clients report TransUnion is more expensive than they would like, resulting in a perception of being nickel-and-dimed or the feeling that the vendor does not exceed expectations. Notably, this sentiment is not shared by deep adopters.

“TransUnion Healthcare does a good job. I actually am very happy with them. They are very good with communications on our bad debt and appeals work. The vendor has helped us recover quite a bit of money. We use the vendor as a second review with DRGs in case we miss things. The vendor finds a few things because of delays with people getting Medicaid applications approved. The vendor finds things late in the game, and we then amend our Medicaid days that we file before the cost report is audited. We use the vendor on a contingent basis. The vendor’s people have expertise.” —Revenue cycle director

About This Report

Each year, KLAS interviews thousands of healthcare professionals about the IT products and services their organizations use. These interviews are conducted using a standard quantitative evaluation, and the scores and commentary collected are shared in reports like this one and online in real time so that other providers and IT professionals can benefit from their peers’ experiences. To enable readers to more quickly understand high-level differences in vendor performance and give better context as to how each product compares to other offerings in the market, KLAS has organized the questions from the standard evaluation into five customer experience pillars—loyalty, operations, services, relationship, and value.

customer experience pillars services

The data in this report was collected over the last 12 months; the number of unique responding organizations is given in the chart below.

about this report

What Does “Limited Data” Mean?

Some services are used in only a small number of facilities, some vendors are resistant to providing client lists, and some respondents choose not to answer particular questions. Thus a vendor’s sample size may vary from question to question and may not reach KLAS’ required threshold of 15 unique respondents. When a vendor’s sample size for a particular question is less than 15, the score for that question is marked with an asterisk (*) or otherwise designated as “limited data.” This report also measures a subset of vendors’ client bases: deep adopters. All scores from deep adopters are based on samples of at least 3 unique organizations and are marked as limited data. Note that when a vendor has a low number of reporting sites, the possibility exists for KLAS scores to change significantly as new surveys are collected.

Overall scores are measured on a 100-point scale and represent the weighted average of several yes/no questions as well as other questions scored on a 9-point scale.

author - Amanda Wind Smith
Amanda Wind Smith
author - Jess Wallace-Simpson
Jess Wallace-Simpson
author - Natalie Jamison
Project Manager
Natalie Jamison
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This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2024 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.