Revenue Integrity Healthcare

Our Case Studies

We’re Proud of Our Success

We are proud to have helped over 200 hospitals recover lost revenue and optimize their EMR systems—here are just some of our best success stories.

Total Amount Secured

$19.2 Million

One large Southeast Hospital noticed its revenue was millions of dollars less than expected three months following a complete implementation of Oracle Cerner Millennium, including Patient Accounting. Our software was able to instantly identify nearly $4.8 million in lost revenue that other analysts had missed for three months.

Problems

  • Ordered tests were always not being charged
  • Inconsistent charges from one specific location

Tool

  • Panther Charge Integrity Control

Solutions

  • Corrected build and workflow issues in EMR
  • Repaired workflow design issue with charges
  • Identified orderables that never posted charges

Total Amount Secured

$1,500+ Weekly

Midland Health had invested a significant amount into their EHR system but was struggling to find missing revenue and claims that weren’t posting charges. Using Softek’s advanced software solutions, they were able to stop leakage and repair dysfunctional revenue streams

Problems

  • Struggling to find missing revenue
  • Certain claims weren’t posting charges

Tool

  • Panther Charge Capture

Solutions

  • Identified leakage within pharmacy
  • Identified missing EKG charges
  • Repaired charging for blood transfusions

Total Amount Secured

$1 Million

During our engagement at one health system in Florida, we noticed issues with their revenue integrity in healthcare and billing systems related to orders not posting charges consistently. Through the use of our advanced software, we were able to help identify which orderables had missed charges and for which patients.

Problems

  • Inconsistent EMR structure and organization
  • Many payments were being missed or declined

Tool

  • Panther Charge Integrity Control

Solutions

  • Identified inconsistent charging within the Gen Lab
  • Identified mislabeled oderables causing missed charges
  • Confirmed the orderables are now posting to date

Total Amount Secured

Over $240,000

Using Softek’s Formulary Compliance Control, our consultants found 127 QCF build issues that were leading to missed reimbursements at a large western hospital. Our Formulary Compliance Control also identified 2,784 expired NDCs, 366 that were causing Medicare to deny payments, as well as two drugs missing HCPCS codes leading to denials.

Problems

  • No consistent auditing system in place
  • Outdated internal records leading to denied payments

Tool

  • Panther Formulary Compliance Control

Solutions

  • Found 127 QCF build issues
  • Identified two drugs missing HCPCS codes
  • Identified which orderables had missed charges

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Total Amount Secured

$2.5 Million

Revenue at one Midwest regional medical center was down six months after going live with Oracle Cerner clinical applications. Using the Charge Integrity Control inside our proprietary Panther technology, Softek’s Revenue Consulting team had instant visibility into charging gaps within each department. With our our unique visibility into the EMR, we identified 10 different orderables with a manual change to the technical tier that had led to missing technical charges.

Problems

  • Leakage was suspected but not identified
  • Some orderables were missing technical charges

Tool

  • Panther Charge Integrity Control

Solutions

  • Identified 10 orderables with manual changes on technical tier
  • Advised client on correcting the system build in its technical tier
  • Assisted client with correcting orderables for the previous 30 days

Total Amount Secured

$3 Million

Revenue at one Southern academic medical center was down six months after going live with Oracle Cerner clinical applications. Softek’s Revenue Consulting team used reports within our Panther Charge Capture technology to quickly locate the source of this six-month-old problem.

Problems

  • Revenue was significantly lower than projected
  • Record management issues caused by poor visibility into EMR

Tool

  • Panther Charge Services Report

Solutions

  • Identified errors in the Pharmacy No-Cost Ingredients Report
  • Advised client on manually correcting costs
  • Assisted client with correction of system build

Total Amount Secured

Over $400,000

The client had a system change that led to inconsistencies in charging. Softek’s Charge Integrity Control compares patient orders and corresponding charges along the entire transaction process. Softek consultants were able to find $270,000 in missed charges within Radiology over a one-day span. Within Gen Lab alone, there was $143,000 in missed charges.

Problems

  • System changes were not synced within EMR
  • No charge audit system in place

Tool

  • Panther Charge Integrity Control

Solutions

  • Compared patient orders to charges
  • Established scheduled system audits
  • Reorganized EMR charge flow

Total Amount Secured

Over $500,000

Using Softek’s Formulary Compliance Control, our consultants found 10 reimbursable drugs with QCF issues in a southeastern hospital. In total, these issues caused over $500,000 of missed reimbursement for the client over the prior six months.

Problems

  • Unidentified QFC issues on reimbursable drugs
  • Consistently missing reimbursement

Tool

  • Panther Formulary Compliance Control

Solutions

  • Reorganized flow of records in EMR
  • Resolved QFC issues
  • Established regular auditing system

What Our Clients Have to Say

Our clients have had great experiences with our Panther technology.

As part of their service, Softek designed a Charge Reconciliation process that is auditable and gives our executives visibility on how each department is doing. Its flexibility allowed Softek to quick…

Anthony Adkins

Director of Application Services, Cabell Huntington Hospital

The only thing I would do differently with Softek would be to engage them on the system build months earlier. I wish I had found Softek earlier.

Chief Financial Officer

Softek has brought more bang for my buck than I ever could have imagined. They deserve every bit of the money. I really couldn't ask Softek to do anything more than they do. In fact, in every way Soft…

Director

Invaluable does not do it justice when talking about Softek’s impact. When we brought Softek on, it helped us make Cerner better. We could not have done it without Softek. I can’t say enough good …

Rhonda Lupardus

Midland Health

Softek is absolutely worth their value. The reason that they excel is that they have developed a product that closes a gap with Cerner. Softek isn't developing a product that is going to make us want …

Manager

Softek has listened and cared about the needs of our departments. Softek has worked diligently with our patient accounting office and as a result, we can actually work within our electronic health rec…

Priscilla Smith

Director of Revenue Integrity

Anyone struggling with the Cerner revenue cycle system really needs to get Softek in the room. They are experts with the Cerner system. The EMR transition was such a huge task. We have to start with t…

Chief Financial Officer

Softek develops products that we don't even think we need until we see them. The firm is actively looking for ways to enhance our revenue capture and cash productivity. Everybody can do better. People…

Director

Without Panther, we could have been billing incorrectly for a long time without identifying broken connections within Cerner. It was through the Panther process when we were reviewing the findings and…

Director

Softek’s engineers seem to know our third-party revenue cycle system better than anybody else I have ever worked with. They understand and know what tables to pull respective information from. They …

Manager

What was intriguing was Softek's focus, specifically on Cerner clients. We have found the ability to audit and trail things within the Cerner charge process to be problematic. Softek was incredibly ge…

Director

I love Softek. They are one of the best firm partners that I have worked with for being such a small, agile company. I can't say enough good things about Softek. They aren't a firm; they are a partner…

Director

Softek delivers and communicates. They are there and respond in a timely manner. But more importantly, they don't wait for us to come up with a problem for them to solve. Softek knows the system well …

Director

Softek has a different perspective because they work with so many health systems, and they look across all of those organizations and circle back. The vendor has added various tools inside of their pr…

Manager

I would encourage everybody that is doing a Cerner implementation for revenue cycle and charge services to use Softek's consulting services. Softek's consultants teach us how to use the system while i…

Director

We have known about Softek for years, and we thought they looked like a pretty good company. Then they built a financial tool. We heard that everybody wished that they had bought Softek's services bef…

Director

Softek has a different perspective because they work with so many health systems, and they look across all of those organizations and circle back. The vendor has added various tools inside of their pr…

Manager

We are pleased with Softek’s service delivery. They have been an invaluable asset in our progress throughout the Cerner Millennium implementation. We don’t just see Softek as a vendor, but also as…

Anthony Adkins

Director of Application Services, Cabell Huntington Hospital

Softek doesn't promise that they can do something and then not do it. When we give them feedback, within a week’s time, they check in to see whether we can log in and to see whether things are any b…

Director

We have known about Softek for years, and we thought they looked like a pretty good company. Then they built a financial tool. We heard that everybody wished that they had bought Softek's services bef…

Director

We brought Softek in on our project, and they gave us a deal. They gave us a consultant to really support us, and that person had an amazing knowledge set. They were almost like an extension of our te…

Director

They are very customer focused. Working with Softek has just been very refreshing in that respect because a lot of other vendors of tools that we have always have user enhancements, but that is such a…

Director

Softek’s tools give me confidence we are catching what we need to. They’ve given us a broader view of where the revenue leaks are. It makes my day much easier. If we’re leaving something on the …

Rhonda Lupardus

Midland Health

The vendor was not only looking at trying to perfect a tool that they developed but also constantly looking for growth opportunities. Softek is always looking for ways to make the tool better. The ven…

Director

We really like that Softek has a tremendous knowledge of Cerner. Softek is extremely responsive, and they go above and beyond what other vendors normally do. Softek delivers on what they say they are …

Manager

Softek has been able to develop some new productivity tools for us where we can really gauge the productivity of our team members. A huge gap for us has been getting valid productivity without having …

Manager

As Cabell Huntington Hospital prepared to go live with Cerner Millennium, we needed a system to help us transition smoothly to avoid revenue loss during the implementation. Prior to selecting Softek, …

Anthony Adkins

Director of Application Services, Cabell Huntington Hospital

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