Services

Surgery and Emergency Room Revenue Integrity

The operating and emergency rooms are among the most complex and financially critical areas of any hospital. Fast-paced environments, documentation gaps, and system limitations often lead to missed charges, inaccurate coding, and lost revenue.

Net Revenue offers revenue integrity solutions designed to identify and recover these opportunities while driving long-term operational improvement.

We combine clinical, financial, and coding expertise to deliver a consistent and accurate billing methodology across surgical and ER departments. Our approach includes:

  • Comprehensive review of charge protocols to identify missed revenue opportunities
  • Clinical audits conducted by experienced surgical nurses and specialists
  • Evaluation and enhancement of documentation to support accurate coding and billing
  • Optimization or development of E&M leveling tools for emergency services
  • Staff education to strengthen collaboration between clinical and revenue cycle teams
  • Full-service re-billing of missed charges and codes to drive immediate cash recovery

All findings and recommendations are transparently shared with your team, and we work alongside your staff to implement solutions—ensuring both immediate financial impact and sustainable, long-term results.

Value Added Services

Underpayment Analysis

Net Revenue provides a complementary underpayment analysis with no additional data required. The analysis is conducted based on our standard OR and ER review. Our analysis specifically includes reviewing traditional underpayment claims to determine how much is being left on the table.

We also conduct payer contract reviews to help ensure agreements are optimized for hospital performance. Our team manages the review process and works directly with insurance companies so that contract terms are favorable for hospitals.

No Surprises Act

The No Surprises Act (NSA) provides federal protections against surprise billing for certain types of medical care.

Many hospitals do not manage this process effectively. As a result, payers pay out-of-network and the hospital misses out on higher in-network rates.

Net Revenue consults with clients on documentation and billing requirements to bring processes into compliance. Our solution audits out-of-network claims to determine incorrect adjudication. We then negotiate with payers for appropriate payment and, if needed, file dispute resolutions to ensure full reimbursement.

Vendor Management

Any hospital will find our vendor management services useful, particularly rural hospitals. Our vendor management services include 3 key components:

Vendor Report Card: We look at vendor agreements to ensure hospitals are paying a fair rate and that the terms are favorable. This includes analyzing compliance, at-fault instances, and insurance levels. We then review historical performance reports to ensure vendors are performing at an acceptable level.

Consulting: In short, we help the hospital manage vendors. We do this so that hospital staff do not have to worry about managing vendors, and allows them to focus on their responsibilities. The consulting component includes inputting data into a vendor management system, holding monthly performance reviews, and managing processes.

Reporting System: Lastly, we provide the hospital and staff with a custom vendor management tool that monitors vendor performance against goals you set, thus allowing hospitals to hold vendors accountable using mutually agreed-upon performance metrics. This ensures an objective perspective of the vendor’s performance.

Our approach is broken down into a three-step process that focuses on optimal results for our clients, with minimal support by you and your staff and a fee structure that is 100% contingency fee-based.

Missed Opportunities

The Hospital CEO and CFO Guide to Recovering OR and ER Charges

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Missed Opportunities

The Hospital CEO and CFO Guide to Recovering OR and ER Charges

Contact Form

Name(Required)