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Revenue Integrity/Underpayment Services 2021
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Revenue Integrity/Underpayment Services 2022 Revenue Integrity/Underpayment Services 2022
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Revenue Integrity/Underpayment Services 2022
Finding the Firm That’s Right for Your Organization

author - Mollie Hunt
Mollie Hunt
author - Alex McIntosh
Alex McIntosh
author - Tyler Sycamore
Tyler Sycamore
April 7, 2022 | Read Time: 9  minutes

Overall, healthcare organizations are highly satisfied with the firms they engage to tackle difficult revenue-collection issues, such as underpayments, denials, and complex government reimbursement requirements. However, different firms focus on different revenue integrity areas, making side-by-side comparisons difficult. To help organizations identify which firms best fit their needs, this report (1) looks at how well firms educate clients on ways to proactively avoid missed revenue, (2) highlights firms’ client-validated areas of expertise, and (3) examines each firm’s specific strengths and opportunities for improvement.

Note: The data in this report comes from two different surveys. Not all respondents answered both surveys, so sample sizes vary throughout the report. See About This Report for more information.

Revecore and Cloudmed Offer Outstanding Proactive Education; TransUnion Healthcare Falls Short

impact of firms proactive education on client success

Though educating clients on ways to improve their internal processes and proactively prevent revenue leakage may not be an explicit feature of a firm’s offered services, clients highly appreciate firms that do this well. Revecore and Cloudmed clients say the firms excel in helping them develop more effective collection processes. The firms meet regularly with clients to discuss process changes that will help avoid future denials; they provide training for clients’ staff and share their broad knowledge to help clients improve their revenue cycle management. TransUnion Healthcare is less consistent in providing this guidance. Clients note that the relationship feels more transactional than proactive and say that the quality of the firm’s staff has declined somewhat over the past 12 months as seasoned employees have left and been replaced with less-experienced resources.

Which Firms Have Core Expertise in the Areas You Need?

Healthcare organizations aren’t typically looking for a one-stop shop when it comes to revenue integrity/underpayment services, and they tend to hire firms for specific expertise in one or two areas. 100% of Aspirion respondents use the firm for denials management, with underpayment recovery being another commonly engaged area. Almost all interviewed BESLER clients engage the firm for transfer DRG services. Cloudmed is frequently utilized for underpayment recovery, and just under one half of interviewed clients use them for transfer DRG services. 95% of clients engage Revecore for underpayment recovery, and just below 50% chose the firm for denials management. TransUnion Healthcare has a heavier technology focus than the other firms in this report and is most commonly utilized for help with Medicare reimbursement.

client validated engagements

Aspirion: Nearly All Respondents Report Exceeded Expectations

overall satisfaction vs exceeds expectations

Aspirion’s primary niche is denials management, though more than half of interviewed clients also use other revenue integrity services from the firm. All interviewed Aspirion clients are satisfied or highly satisfied with the firm’s ability to overturn denials and collect lost or missing revenue, and they are the client base most likely to feel that their firm exceeds expectations. The Aspirion staff is described as highly knowledgeable, and the firm is noted for being completely transparent—clients say Aspirion provides frequent updates as well as detailed notes and documentation. Clients report that the firm stands out from others for their robust understanding of market intricacies. Unique compared to other client bases interviewed for this report, Aspirion respondents frequently mention the strength of the firm’s legal expertise, noting that each engagement includes a trained attorney.

“Aspirion is probably one of the most partner-based vendors we run into in the industry. I don’t usually give out high scores, but the vendor support people are pretty impressive. They know things. . . . The vendor is fully transparent about their performance and findings. The vendor’s performance exceeds what we would expect in this space. Their performance is solid and consistent. Aspirion’s metrics demonstrate those things.” —Executive director of revenue cycle

BESLER: Staff Expert at Helping Clients Prevent Missed Revenue

quality of staff consultants

Nearly all interviewed BESLER clients use the firm for transfer DRG services; the firm is also commonly used for underpayment recovery and Medicare reimbursement. BESLER clients report high satisfaction with the firm’s expertise and the quality of their staff. Clients note that BESLER’s resources are highly knowledgeable in identifying potential lost revenue and are able to work independently without hand-holding from the clients. Many respondents say the firm has exceeded their expectations, bringing in more revenue than expected and then identifying internal processes that clients can adjust to prevent missed revenue going forward. Clients also highlight the firm’s efficiency, which allows claims to flow more effectively.

“BESLER is great to work with. They are sharp, and their subject matter experts know what they are talking about. BESLER stays on top of everything going on with CMS. . . . BESLER does good reporting, and they are very responsive when we have a concern with anything they are doing. If we want BESLER to stop doing something, they stop. If we want them to try something different, they try something different. BESLER knows what they are doing, and they are compliant and ethical in their approach.” —Director of revenue cycle

Cloudmed: Most Clients Highly Satisfied; Former Triage Clients Report Post-Merger Dip

overall performance score 2020 to 2022Cloudmed was formed in 2020 by the merger of Revint and Triage Consulting Group, and this report sample includes feedback from both client groups. Overall, clients are highly satisfied with the rebranded Cloudmed experience and are achieving desired outcomes. However, some former Triage Consulting Group clients report a noticeable decline in executive involvement and strategic ability. They say the high levels of personal interaction and proactive guidance they received from their former firm have waned, and interactions with Cloudmed feel less strategic and more salesy. For example, one respondent wonders whether they get their money’s worth since they have to invest more internal resources than expected to move the Cloudmed work and relationship forward. Satisfaction among former Revint clients has remained steady. They generally feel they get their money’s worth and are highly likely to recommend Cloudmed’s services. Some note that the relationship is starting to feel more transactional, and some report delays with things like getting more payers added to the system or getting up-to-date on the platform.

“Cloudmed is good to work with. They make their services pretty simple and straightforward. Once the project has been launched, Cloudmed does a good job of taking things from there and driving benefits for us. From that perspective, we have been pleased. We were able to negotiate pretty successfully for a good contract rate. We haven’t encountered any challenges or issues. . . . I would like to see at least quarterly updates from the vendor and more executive engagement beyond just the sales cycle. The updates would be the biggest areas of opportunity. . . . There should be more executive engagements with executives.”  —Business office VP

Revecore: Collaborative Partnership a Strong Satisfier

likely to recommend 2020 to 2022

Revecore is used most commonly for underpayment recovery services; additionally, nearly half of respondents also use the firm for denials management. Respondents have steadily become more likely to recommend Revecore over the last two years as the firm has strengthened client relationships; Revecore is seen as a collaborative partner rather than a services provider. Many clients highlight the firm’s flexibility in meeting clients’ needs and note that Revecore’s staff is deeply knowledgeable and invested in client success. The firm’s reporting is another key strength. Multiple respondents highlight its benefits, saying it enables them to identify trends and then work to improve internal processes and efficiency. A few respondents report that Revecore could still be doing more. These clients note uncertainty about whether Revecore is chasing all possible revenue.

“Revecore has unique tracks, but they offer a partner approach. They don’t nickel-and-dime or try to preserve their seat at the table. Revecore is really about mutual partnership. They do very well with collaboration, knowledge transfer, and other things that help us improve our processes. We can be assertive regarding our business needs. I have always found that Revecore is very responsive to our needs.” —Business office VP

TransUnion Healthcare: Delivery across Clients Not Consistent; Some Left Wanting More

is firm viewed as long term partnerTransUnion Healthcare is most often used by interviewed clients for Medicare reimbursement; about one-quarter use the firm for insurance discovery or transfer DRG services. Respondents describe TransUnion’s rates as competitive and highlight the firm’s willingness to work with clients on pricing. Based on the results they achieve, clients feel they get a good value for what they pay. Over the last year, some clients have reported a decline in TransUnion’s communication and responsiveness, with some saying they don’t know who their point of contact is. Additionally, some respondents note that representatives and firm executives no longer reach out to them to share insights and market knowledge, and clients’ questions and requests sometimes go unanswered. The poor communication as well as turnover among TransUnion’s staff has caused a decline in the quality of work. Inadequate reporting is another concern for some clients. Due to these issues, over one-quarter of respondents question whether TransUnion will be a good fit as a long-term partner. TransUnion was acquired by nThrive in December 2021.

“The service from TransUnion Healthcare is predictable, and that is kind of the point. There is no guessing, and that is nice. . . . Right now, things are just fine. . . . TransUnion Healthcare had some turnover, so there was a period of a few months where I was confused about who to send things to. There were also issues with communication. There were a few times when I sent TransUnion Healthcare data, and months later, I would get an email asking whether I was going to send them the data I had already sent them. I don’t know what was going on there.”  —Remittance manager

Additional Validated Firms

In addition to the firms covered in this report, survey respondents also mentioned additional services firms and technology vendors as being used for specific areas of revenue integrity/underpayment services. As warranted by market interest, these and other firms may be added to KLAS’ future research.

Charge capture

Health Catalyst
nThrive Revenue Systems
Vitalware by Health Catalyst

Denials management

xTend Healthcare

DRG validation


Medicare reimbursement

Genesa Reimbursement Group
HRA (Healthcare Reimbursement Associates)

Transfer DRG

Comprehensive Reimbursement, Inc. (CRI)

About This Report

Each year, KLAS interviews thousands of healthcare professionals about the IT solutions and services their organizations use. For this report, interviews were conducted over the last 18 months using KLAS’ standard quantitative evaluation for healthcare services, which is composed of 9 numeric ratings questions and 3 yes/no questions, all weighted equally. Combined, the ratings for these questions make up the overall performance score, which is measured on a 100-point scale. The questions are organized into five customer experience pillars—loyalty, operations, relationship, services, and value.

customer experience pillars

To supplement the customer satisfaction data gathered with the standard evaluation, KLAS also asked a subset of respondents several supplemental questions tailored to the revenue integrity/underpayment services market. These questions asked respondents (1) to rate the impact their firm’s education/knowledge transfer has had on their organization’s success and (2) whether they see their firm as a long-term partner capable of meeting future needs. Sample sizes for these two questions are smaller than those for the standard evaluation.

Sample Sizes

Unless otherwise noted, sample sizes displayed throughout this report (e.g., n=16) represent the total number of unique client organizations interviewed for a given firm or service. However, it should be noted that to allow for the representation of differing perspectives within any one client organization, samples may include surveys from different individuals at the same organization. The table below shows the total number of unique organizations interviewed for each firm or service as well as the total number of individual respondents.

Some respondents choose not to answer particular questions, meaning the sample size for any given firm or service can change from question to question. When the number of unique organization responses for a particular question is less than 6, the score for that question is marked with an asterisk (*) or otherwise designated as “limited data.” If the sample size is less than 3, no score is shown. Note that when a firm has a low number of reporting sites, the possibility exists for KLAS scores to change significantly as new surveys are collected.

about this report
author - Elizabeth Pew
Elizabeth Pew
author - Madison Moniz
Madison Moniz
author - Isaac Burgi
Project Manager
Isaac Burgi
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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.