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

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

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

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 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 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