Revenue Integrity and Billing page

Revenue Integrity and Billing

Enterprise revenue integrity support across medical coding, DRG validation, clinical documentation integrity, documentation compliance, denials, and payment accuracy, with dashboards that drive measurable improvement.

Request a Revenue Integrity Review

Visual module: KPI scorecard strip

Coding accuracy and variance

DRG accuracy and case mix integrity

Documentation completeness rate

Denial rate and overturn rate

Underpayment variance rate

Days in AR

Example visuals shown. Final dashboards vary by organization.

Who we serve

Keep it short, three chips or cards.
Built for

Hospitals and health systems

Private physician groups

Private outpatient centers

Revenue integrity map

Where integrity breaks and revenue leaks

Clinical documentation integrity
Documentation compliance
Medical coding and modifier accuracy
DRG validation and case mix integrity
Charge capture and charge lag
Claims edits and rework
Denials and appeals
Underpayments and contract variance
Payment posting and reconciliation
Reporting and governance cadence

We prioritize fixes by financial impact, compliance risk, and speed to correct, then track performance month over month.

Services

Medical Coding

Coding alignment, modifier accuracy, and variance reduction across service lines.

  • DRG audits
  • Query support
  • Trending

DRG Validation

DRG validation and case mix integrity review to reduce reimbursement risk and improve accuracy.

  • DRG audits
  • Query support
  • Trending

Clinical Documentation Integrity

CDI workflows that improve documentation quality, reduce denials, and strengthen coding accuracy.

  • Query workflows 
  • Provider enablement
  • KPI tracking

Documentation Compliance

Documentation compliance checks and audit readiness support aligned to payer and regulatory expectations.

  • Risk flags
  • Audit prep
  • Standard work

Denials Reduction and Appeals

Denial taxonomy, root cause fixes, and appeal playbooks that reduce repeat denials.

  • Denial drivers
  • Appeals workflow
  • Trending

Underpayment and Payment Integrity

Underpayment detection, contract variance review, and recovery workflow with reporting.

  • Variance flags
  • Recovery tracking
  • Scorecards

What you receive

Underpayment detection, contract variance review, and recovery workflow with reporting.

Baseline KPI scorecard

Baseline KPI scorecard

Findings by domain (coding, DRG, CDI, compliance)

Findings by domain (coding, DRG, CDI, compliance)

Priority fixes ranked by impact and risk

Priority fixes ranked by impact and risk

Playbooks and standard work

Playbooks and standard work

Education plan and accountability cadence

Education plan and accountability cadence

Monthly dashboards and issue log

Monthly dashboards and issue log

Engagement options

Our engagement process is straightforward and aligned with how we approach radiation oncology and
radiology:

Revenue integrity review

Review plus implementation

Ongoing integrity oversight and dashboards

Oncology specialization callout

Specialty depth in oncology

TNM brings deep oncology operations experience, so oncology service lines receive specialty specific workflows, documentation guidance, and revenue integrity support aligned to real clinical delivery.

Ready to improve revenue integrity

Share your organization type, service lines, systems, and top revenue challenges. TNM will respond with a defined scope and next steps.
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