SYSTEMS AND METHODS FOR MINIMIZING REVENUE LEAKAGE BY IMPROVING COMORBIDITY CODING AND LOWERING THE MORTALITY INDEX WHILE INCREASING INPATIENT REVENUE

摘要

Systems and methods for reducing revenue leakage involve identifying from a database containing information regarding treatment of a patient by a medical services provider and conducting a keyword search within the database based on keywords commonly associated with billable services. When a keyword of interest is located within the database, a data mining search of words preceding and following the located keyword of interest is conducted to identify any modifiers relevant to the located keyword of interest. Then, the located keyword and any identified modifiers are used to identify one or more unbilled services, and action is taken to facilitate billing of the one or more unbilled services. The ability to access data from multiple disparate data sources utilizing NLP, Virtual Machines and HL7 messaging will benefit the service provider by improving processes and training clinicians how to be more succinct and to find all appropriate opportunities to recognize revenue when costs have been incurred.