EldoNova+ HIM+: Revolutionizing Revenue Cycle Management and Clinical Documentation
EldoNova+ HIM+ is a powerful Revenue Cycle Management (RCM) platform designed to enhance clinical documentation, improve coding accuracy, and prevent revenue loss. By providing comprehensive tools for Clinical Documentation Improvement (CDI) specialists, coders, clinical validators, and healthcare providers, HIM+ ensures efficient and accurate claim submissions, reducing the risk of denials and optimizing revenue generation.
What is HIM+?
HIM+ is a state-of-the-art platform that bridges the gap between clinical documentation, coding accuracy, and revenue cycle management. Built to prevent DRG (Diagnosis-Related Group) denials and reduce revenue loss, HIM+ supports providers in both inpatient and outpatient settings by improving clinical documentation workflows, auditing claims before submission, and ensuring accurate code validation.
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Key Features of HIM+
1. Clinical Documentation Improvement (CDI)
HIM+ is a robust tool that empowers CDI specialists to improve the quality and accuracy of clinical documentation, ensuring that it supports the diagnoses and treatment plans. This leads to better coding accuracy, fewer denials, and optimized reimbursement.
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Enhanced Documentation Workflow: Streamlines documentation processes for providers to capture complete and accurate clinical details.
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Real-Time Alerts: CDI specialists receive notifications of documentation gaps or missing details, helping prevent coding errors.
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Compliance Tracking: Ensures documentation aligns with clinical guidelines and payer requirements, reducing the risk of claim rejections.
2. Accurate Coding for Coders
HIM+ assists coders in selecting the correct codes by providing decision support based on clinical documentation and coding rules. This ensures that every diagnosis, procedure, and treatment is accurately reflected, minimizing errors and improving claim acceptance rates.
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Automated Code Suggestions: HIM+ uses AI-driven tools to suggest the most accurate ICD-10, CPT, and HCPCS codes based on clinical data.
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Comprehensive Code Validation: Built-in logic checks ensure that codes align with clinical documentation, reducing errors and preventing revenue leakage.
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DRG Optimization: The platform ensures that codes accurately reflect the patient’s condition, ensuring proper DRG assignment and preventing DRG denials.
3. Clinical Validators
HIM+ provides clinical validators with a thorough audit mechanism to ensure that every code submitted is supported by clinical documentation, reducing the risk of denials and minimizing revenue loss.
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Pre-Claim Validation: HIM+ audits claims prior to submission, flagging codes that lack supporting documentation or evidence, ensuring all submitted codes are validated.
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Denial Prevention: By identifying and correcting documentation errors before claims submission, HIM+ reduces the likelihood of costly denials and revenue loss.
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Detailed Audit Reports: Clinical validators can review comprehensive audit reports to identify discrepancies and ensure accurate claim submission.
Prevent DRG Denials and Revenue Loss
With HIM+, healthcare organizations can proactively prevent DRG denials and revenue leakage. HIM+ performs thorough audits before claim submission to identify any missing or incomplete documentation that could lead to denials.
Audit Before Claim Submission
HIM+ includes an automated audit feature that reviews claims before submission, identifying any codes that lack sufficient documentation or validation. This proactive approach helps organizations avoid coding errors, ensure compliance, and prevent revenue loss.
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Comprehensive Pre-Submission Audits: HIM+ automatically reviews all codes to ensure compliance with coding guidelines and payer requirements.
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Evidence-Based Code Validation: The system verifies that all codes are backed by complete clinical documentation, reducing the chance of claim denials.
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Compliance Auditing: Ensures that claims adhere to regulations, preventing unnecessary audits from external agencies and minimizing financial penalties.
For Inpatient and Outpatient CDI Programs
HIM+ is an essential tool for both inpatient and outpatient Clinical Documentation Improvement (CDI) programs, helping providers streamline documentation practices and ensure that every code is accurately captured and justified.
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Inpatient CDI: Supports complex inpatient cases with real-time alerts and documentation improvement suggestions to enhance accuracy.
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Outpatient CDI: Provides detailed insights for outpatient cases, ensuring that even short-term or minor care encounters are properly documented and coded.
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Cross-Department Coordination: HIM+ allows for seamless collaboration between CDI specialists, providers, coders, and clinical validators, ensuring that all departments are aligned in the documentation process.
Why Choose HIM+ for Your Organization?
Complete Revenue Cycle Management
HIM+ is an end-to-end RCM solution that not only improves clinical documentation and coding accuracy but also ensures compliance, reduces denials, and maximizes revenue for healthcare organizations.
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Proactive Denial Management
HIM+ includes advanced tools for denial prevention, ensuring that claims are submitted correctly the first time, reducing delays and the need for rework.
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Audit and Compliance Safeguards
With HIM+, all claims are thoroughly audited before submission, reducing errors, improving compliance, and protecting your organization from revenue loss.
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Tailored for Inpatient & Outpatient Care
Whether you’re dealing with complex inpatient cases or fast-moving outpatient care, HIM+ is designed to meet the unique documentation and coding needs of your organization.
Optimize Revenue and Compliance with EldoNova+ HIM+
The EldoNova+ HIM+ Platform is the ultimate solution for organizations looking to enhance clinical documentation, prevent DRG denials, and ensure accurate, timely claim submissions. With HIM+, healthcare providers can streamline their documentation and coding processes, prevent revenue loss, and improve compliance with ease.
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Ready to take your revenue cycle management to the next level?
Contact EldoNova+ today and discover how HIM+ can transform your healthcare operations.