Practice Group

Inpatient Hospital

An innovative, proactive approach to administration, documentation, coding, billing, and compliance.

Inpatient hospital stays, procedures and protocols have come under intense scrutiny in recent years. That’s why hospitals are turning to Granite GRC’s Inpatient Hospital practice group for trusted guidance and support. With insurance companies, government regulators and agencies probing all aspects of operations, our team of experts can help you optimize your revenue cycle administration, including documentation, coding, and billing for strong, proven results.

Addressing Needs and Challenges

Our Inpatient Hospital team assesses documentation for patient encounters and evaluates for accuracy, consistency, and compliance. Our services include:

  • Documentation, coding and DRG assignment and validation
  • Length-of-stay reviews to determine medical necessity
  • Hospital readmissions/quality measures
  • Denials management

We help hospital administrators adopt leading-edge technologies to improve patient service and care, streamline workflow, identify and address pain points, increase receivables and ensure compliance. Further, we assess and analyze systems and transactions; perform, consult on and provide support for internal investigations; evaluate and manage third-party risk, including providing credible, risk-appropriate resolutions, corrective and preventive actions; and more.

Further, we assess and analyze systems and transactions; perform, consult on and provide support for internal investigations; evaluate and manage third-party risk, including providing credible, risk-appropriate resolutions, corrective and preventive actions; and more.

Our dedicated team is well-versed in all facets of the revenue cycle:

  • Payor contracting, including FFS, PPS, risk adjustment, capitation, bundled payments, value-based, shared savings, and other payment models.
  • Healthcare revenue cycle management, from credentialing through appeal of denials.
  • Concierge and cash medicine models.
  • Documentation, coding and billing reviews and analyses.
  • Medicare Incentive Payment System analyses and improvement.
  • Charge-capture analysis and credit-balance reviews.
  • Denials management and appeal.
  • Credit-balance reviews.
  • Voluntary and mandatory self-reporting.

We’ll work with your facility and train staff using proven methods, holding ourselves accountable during the process.

  • We immerse ourselves in your practices and procedures, identifying risks, noncompliance issues and areas needing improvement.
  • We develop strategies and training schedules to help your team make and meet goals.
  • We fortify your staff with the tools to improve operations and understand the best way to implement these strategies.

“Proper coding and Diagnoses Related Groups (DRG) assignment and validation are critical steps in every patient encounter. Precise and accurate documentation and coding are the foundations of proper reimbursement, strategic planning, fiscal administration and much more. Our team evaluates and identifies areas of concern in your organization’s systems and offers strategies to correct inconsistencies and avert potential problems.”

– from Crystal Stalter, Director of Revenue Cycle Assessment and Compliance

Trusted Guidance, Hands-On Approach

Our trusted advisors are recognized authorities in their areas of expertise, many with more than three decades of healthcare industry experience working inside enterprises similar to yours. They’ve sat in your seat and have known what it’s like to address concerns from inside an organization. We use that experience to work hard to find great solutions that benefit you.

  • We communicate frequently and transparently with your team about their goals and ensure they understand what’s expected of them.
  • Our strategies help leadership and staff to hold themselves accountable.
  • We measure and monitor progress regularly and offer reports that let you change course and redirect resources when necessary to eliminate processes that aren’t working and amplify those that are.
  • We streamline operations for greater efficiencies that can improve morale and communication, reduce turnover, and so much more.

“After we identify the issues throughout your organization, together we address your most pressing challenges, recommend solutions and design customized programs and training. We are passionate about helping your team achieve success.”

– from Crystal Stalter, Director of Revenue Cycle Assessment and Compliance

Partnering with You for Success

The certified professionals in our Ambulatory Surgical Center Practice Group are committed to helping you implement strategies in areas that need improvement and make your high-performing areas even stronger.

Solutions to common challenges that we provide include:

  • Revenue cycle assessment, including documentation and claims review, claims denials and operations
  • Medical litigation review for coding and documentation suits
  • Ensuring corporate compliance

Our Ambulatory Surgical Center team garners exemplary reviews for identifying issues and pain points, designing solutions to correct problems with measurable results, amplifying best practices, and for outstanding customer support.

We measure our success by your success — and we won’t stop until your team has the tools to excel, and the knowledge needed to identify optimal ways to execute these strategies independently.

Success Story

Granite GRC provides ongoing support to a large mid-Atlantic hospital, with focus on coding and documentation standards for the providers, coding, QA and CDI staff to achieve compliant optimization of their revenue cycle.

“For years Granite GRC has provided our health system with insightful analysis leading to improved reimbursement and compliance across all of our lines of business. Their experienced, skilled consultants, auditors and trainers tailor their work to us, and are highly responsive to our needs, providing clear, practical advice and well-written reports. I highly recommend Granite GRC to any organization seeking a great relationship with highly experienced professionals that bring strong value for their cost.”

-from Ann E. Bergey, RN, MSOL, CPCO, Vice President Medical Staff Services, Atlantic General Hospital

Meet the Inpatient Hospital Team Lead

Crystal R. Stalter, CPC, CCS-P, CDIP, CCDS-O

Director of Revenue Cycle Assessment and Compliance, Inpatient Hospital Team Lead

Author, speaker and Director of Revenue Cycle and Compliance, Crystal Stalter is nationally recognized as an authority in healthcare best practices, medical coding, clinical documentation, natural language processes and artificial intelligence (AI). She brings 20 years of experience in revenue cycle management, compliance, practice management, strategy, training, coding operations, communications, data analysis and more, providing superior guidance and helping healthcare professionals achieve excellence in facility management and patient care.

Rick Reed

Senior Consultant

Rick Reed is an experienced compliance and privacy officer and attorney with over 20 years of experience leading companies in their efforts to design, build and maintain effective and efficient compliance and privacy programs. Rick is skilled in handling multiple member and multiple jurisdictional data breaches. He interprets HIPAA and GDPR regulations and understands their impact on clinical and business operations. Rick’s work experience spans healthcare payors, heath systems and hospitals, long term care and senior living, diagnostics, and biotech. With a record of forming effective teams, providing support to senior leadership, and effectively communicating meaningful information to all applicable stakeholders, Rick builds successful outcomes for organizations of all sizes.

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