Fragmented UR, CDI, and Coding, rebuilt as one outcome-owned system.
Revexa Clinical Solutions integrates Utilization Review, CDI, Coding, and Quality into a single operating model that gets reimbursement accuracy, quality, and patient safety right the first time.
The problem most health systems live with but rarely name.
The care delivered is not accurately represented in how the system is paid, measured, and publicly reported.
For decades, Utilization Review, CDI, and Coding have run as siloed, finance-driven, volume-based functions. Coders are not clinicians, and the clinical picture is not always reflected in the documentation that drives reimbursement and quality scores. That gap is where systems lose ground.
One integrated model. Three priorities.
Revexa rebuilds Utilization Review, CDI, Coding, and Quality as one operating model where every team shares accountability for the same three outcomes.
Financial accuracy
Get DRG and reimbursement right the first time, so the system is paid for the care it actually delivers.
Quality
Mortality, length of stay, and rankings that reflect true clinical severity and stand up to scrutiny.
Patient safety
Concurrent PSI detection and accurate documentation that protect both patients and public performance.
Vizient Q&A drives every review.
Every review is designed to get DRG, mortality, LOS, and PSI accurate and defensible the first time, so the system wins when it is challenged.
Executive strategy and the workflows that deliver it.
Revexa provides contracted, executive-level support to large health systems and physician practices, across both the hospital and professional billing spaces.
Integrated operating model
Replace siloed UR, CDI, and Coding functions with one clinically led system built around Vizient Q&A, mortality and LOS accuracy, and PSI validity.
Vizient & quality performance
Move teams from volume-based review to ROI and outcome-driven prioritization, with standardized workflows and embedded risk adjustment.
Defensible denials
We do not promise to eliminate denials. We make documentation accurate and appeal-ready so the care delivered is paid for and you win when challenged.
Revenue integrity
Build processes that protect reimbursement, reduce preventable write-offs, and assure payment for the care that was actually provided.
Top-of-license clinical staff
Elevate clinical teams to top-of-license practice, removing low-value rework and focusing expertise where it changes outcomes.
Technology optimization
Optimize the technology you already own, including Epic, before adding new tools, so investment turns into measurable performance.
What top-decile performance actually requires.
Health systems across the country look to Revexa for the tactics and workflows behind top-decile Vizient results. These are the measures every engagement is built to move.
Right the first time, defensible on review.
Reimbursement that matches the documented clinical truth, built to hold up when payers or auditors challenge it.
Observed-to-expected that reflects real severity.
Risk capture and documentation accuracy that align reported mortality with the acuity of care delivered.
Length of stay measured against true expected.
Accurate severity and risk adjustment so length-of-stay performance is judged on the right denominator.
Patient safety indicators caught concurrently.
Concurrent detection and review that prevent invalid safety events from distorting public performance.
Coverage at top-decile levels.
Review rates raised to top-decile so the right charts are reviewed, prioritized by outcome and ROI.
Documentation that wins on appeal.
Appeal-ready clinical defense across UR, UM, and ancillary staff, unified into one model.
Results, in a single year of coordinated work.
Two engagements, both built on the same integrated, outcome-owned model.
Client outcomes shown are de-identified. Geography, facility detail, and exact rankings are withheld to protect client confidentiality. Specifics are available under NDA.
Anne Espinoza
A clinician who saw the gap from the bedside.
Anne is a nationally recognized expert in middle revenue cycle strategy, with demonstrated top-decile performance across CDI, Utilization Review, PSI, Denials, and Vizient metrics.
She began her career as a Registered Nurse in cardiac and neuro ICU, also serving as a Rapid Response Team nurse, code nurse, and house supervisor. At the bedside she saw firsthand that the clinical picture was not always reflected in the documentation driving reimbursement and quality scores. That gap became her work.
Anne moved quickly through leadership roles, standardizing workflows to reach top-quartile and then top-decile performance in revenue, quality, and safety. She expanded into clinical denials and, with a dedicated Physician Advisor and Chief Quality Officer, built a Clinical Denials Hub that unified Utilization Review, Utilization Management, and ancillary staff into one clinical defense model.
Recruited to launch a Professional Billing CDI program for the largest physician practice in Wisconsin, she founded Revexa from that work. Today Revexa advises health systems across the country on healthcare transformation spanning CDI, Coding, Denials, and Utilization Review.
Let us talk.
If you lead Quality, Revenue Cycle, CDI, UR, or Coding and you are tired of fragmented programs and results that are defensible only on paper, start a conversation.