Readmission Review Nurse

FairCode works with leading hospital systems to capture additional revenue and prevent denials by integrating the unique experience and training of physicians directly into the revenue cycle at scale, generating long-term, consistent results. Our founders recognized that the clinical precision a physician brings to billing ensures hospitals have the cash flow and financial health necessary to invest back into patient care. Today, as hospitals face rising costs, increasing patient acuity, flat reimbursements, and growing denial rates, our mission to support accurate billing and improve the broader healthcare system is more important than ever. To meet this challenge, FairCode works with leading hospital systems across the country as a complement to their robust documentation and coding programs. Our 5th generation, AI/ML-powered, proprietary algorithm leverages discharge data, case mix, historical review data, and other factors to zero in on cases that need a physician’s perspective to ensure that the clinical condition of patients is accurately reflected. For each case, our board-certified physicians use their robust clinical experience and training in the fundamentals of coding to interpret the medical evidence, identify gaps in documentation, ensure compliant, defensible coding, and anticipate denials before they happen. To do this at scale, generating long-term, consistent results, FairCode built a proprietary software platform which pinpoints cases and moves them securely and efficiently through the pipeline, capturing physician reviews and delivering transparent, quantifiable results back to the hospital. We also created a client success model where we operate as a seamless extension of the hospital team, driving the performance of the program with flexibility, rigor, and clear analytics so that hospital leadership teams are confident in the results. This unique approach is why hospitals rely on FairCode as a valuable component of their revenue cycle programs.