Revenue Integrity

Improving Accuracy For Tangible Results

Spectrum Management Services Company (SMSC) provides a range of revenue integrity, billing, and medical coding services that help clients improve compliance and identify revenue opportunities. Examples of our success include:

  • Conducting medical coding & charge master audits that have significantly improved compliance and reimbursement at a variety of independent specialty practices.
  • Creating easy-to-use reports that provide high-level summaries as well as drill-down data specific to provider, coder, and modality.
  • Delivering medical coding & physician documentation education services that have improved reimbursement and reduced errors.
  • Developing strategies and actionable recommendations that help clients improve claim submission accuracy, workflow efficiencies and reduce denials.

Key Services

Reviewing client’s existing coding and charge capture practices to identify compliance issues and/or opportunities for revenue enhancement.

Developing action plans to reduce denials and inefficiencies in payor reimbursement.

Determining improper coding, payor and charge master setup, or other issues in the claim preparation and submission process.

Generating user-friendly, personalized reports to summarize audit results and identify specific educational opportunities.

Creating customized education programs to address specific issues.

Assisting clients in developing in-house revenue integrity quality assurance processes based on strengths and weaknesses in existing charge capture, coding, billing, and claims submission procedures.

Providing preparation training to assist in-house staff in achieving Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Revenue Cycle Specialist (CRCS), and other common professional certifications.