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KLAS Crowns Winner of Revenue Integrity/Underpayment Services

Analysis  |  By Scott Mace  
   April 07, 2021

Software helps clients receive owed reimbursements and fix processes that lower payments.

Software incentivized to find every last dollar owed providers has been put through its paces by KLAS, and Cloudmed (Triage Consulting Group) Validated Services has come out on top in the overall rankings.

KLAS' 2019 report on this market examined differences in these vendors' experience and partnership. The Revenue Integrity/Underpayment Services 2021 report builds on that research and compares how the deepest-adopting clients of these vendors compare—clients using the vendor's services across several areas of revenue integrity.

The other software evaluated in this report are Besler Performance Metrics, Revecore Validated Services, TransUnion Healthcare Validated Services, and Cloudmed (Revint) Validated Services. The report also lists the percentage of respondents reporting the following use cases: underpayment recovery, charge capture/audit, denials management, transfer DRG, DRG validation/coding compliance, Medicare reimbursement, and insurance discovery.

The KLAS comparison awarded letter grades in five different areas—loyalty, operations, relationship, services, and value. Loyalty asks providers if they would purchase the software again, overall satisfaction, and would they recommend the software. Operations measures engagement execution. Relationship evaluates executive involvement and strength of partnership. Services compares quality of implementation staff and strategic expertise. Value sums up money's worth, ability of the software to drive tangible outcomes, and whether it exceeds expectations.

The data was collected over the past 12 months. The number of organizations responding to KLAS' survey varied from 19 to 43 standard clients per software package, and from five to 14 deep adoption clients.

Several respondents in the report told KLAS that the October 2020 merger between Cloudmed and Revint has not impacted the relationship or quality of work. Respondents praise Cloudmed (Triage)'s skill at 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.

Scott Mace is a contributing writer for HealthLeaders.


KEY TAKEAWAYS

The KLAS comparison awarded letter grades in five different areas—loyalty, operations, relationship, services, and value.

Loyalty asks providers if they would purchase the software again, overall satisfaction, and would they recommend the software.

Operations measures engagement execution.

Relationship evaluates executive involvement and strength of partnership.

Services compares quality of implementation staff and strategic expertise.

Value sums up money's worth, ability of the software to drive tangible outcomes, and whether it exceeds expectations.


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