Healthcare Revenue Cycle Excellence

Maximizing Reimbursement Through Expert Coding, Documentation & Quality Improvement

Foundation RCM transforms hospital revenue cycles with proven strategies that increase case mix index, capture proper reimbursement, and improve quality metrics while reducing denials.

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Our Core Services

Revenue Cycle Optimization

Comprehensive revenue cycle management focused on improving coding accuracy, clinical documentation, and quality metrics to maximize hospital reimbursement and operational efficiency.

DRG Denial Management

Specialized expertise in preventing and appealing DRG downgrade denials. Our proven strategies recover lost revenue and establish protocols to minimize future denials.

Clinical Documentation Improvement

Expert CDI services that bridge the gap between clinical care and accurate reimbursement, ensuring complete and compliant documentation that reflects true patient acuity.

Medical Coding Services

Professional inpatient and outpatient coding services delivered by certified experts who ensure accuracy, compliance, and optimal reimbursement for hospital systems.

Quality Metrics Improvement

Strategic initiatives to enhance AHRQ and other quality indicators, improving patient safety metrics while positively impacting value-based payment programs.

Full Department Staffing

Complete staffing solutions for CDI, Coding, Billing, and Revenue Cycle departments. We provide experienced professionals who integrate seamlessly with your team.

Proven Results

Case Mix Index Growth

Documented increases in CMI through accurate documentation and coding practices

Revenue Capture

Maximized reimbursement by identifying and correcting undercoding patterns

Quality Improvement

Enhanced AHRQ metrics and hospital quality indicators

Denial Reduction

Significant decrease in DRG downgrades and payer denials

Areas of Expertise

Inpatient Coding & CDI

Comprehensive inpatient services focusing on DRG optimization and accurate severity capture

Outpatient Billing & Coding

Full-service outpatient coding and billing for hospital-based clinics and departments

Appeal Generation

Expert clinical appeal writing for DRG downgrades and medical necessity denials

Compliance & Auditing

Regular audits to ensure coding accuracy and regulatory compliance

Case Mix Optimization

Strategic initiatives to improve case mix index while maintaining coding integrity

Revenue Cycle Analytics

Data-driven insights to identify revenue opportunities and process improvements

Contact Us

Ready to optimize your revenue cycle? Get in touch with our team to discuss how Foundation RCM can help your hospital system achieve financial excellence.

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Phone

956-995-2006