Problem

An Emergency Medicine group was facing pressure from hospital leadership to improve revenue performance or risk losing its contract. While the group understood the seriousness of the situation, it needed a clearer view of whether its current RCM process was accurately capturing the value of the care being delivered. To better understand the issue, the group came to Brault for a second opinion on its RCM performance.  

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Action

Brault conducted a Chart Study using a statistically relevant sample of charts to show how visits would be reviewed, coded, and billed through our specialized EM coding and revenue capture process. The review focused on two key questions: whether physician documentation supported the care provided, and whether the coding process accurately captured the nuance and complexity of emergency medicine encounters.

The study revealed significant under-coding and quantified the financial impact. Just as important, it gave the group objective data to show hospital leadership where revenue was being missed, how performance could improve, and where focused physician documentation training could further support accurate coding and revenue capture.

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Result

The findings helped shift the hospital’s perception of the group by showing that the revenue issue was tied to coding accuracy and documentation opportunity — not the value of the physician group itself. With clear data and a practical path for improvement, the group was able to preserve its contract and strengthen its position with hospital leadership.

The impact was significant enough that the hospital is now considering the group for an additional emergency department contract.

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