Healthcare Solutions

Charge Capture & Coding Optimization

Clinical Documentation Improvement (CDI) specialists struggle to identify undercoding and DRG discrepancies without systematic analysis across provider documentation patterns. When discharge summaries fail to capture the full complexity of care, MS-DRG assignments undervalue the actual resource intensity, resulting in reimbursement shortfalls that are invisible until a post-discharge audit. Coding compliance risk compounds when upcoding patterns go undetected across high-volume procedure codes.

Built For

CDI Manager auditing coding accuracy and documentation completeness across 20+ specialties at a 400-bed acute care facility

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Lumi Care

CDI Specialist

Detects undercoding and DRG discrepancies by analyzing documentation against billed complexity.

DRG Discrepancy Detection
Undercoding Analysis
Documentation Accuracy
CDI Effectiveness
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Lumi Watch

Coding Compliance Auditor

Screens billed codes for upcoding risk and flags patterns that elevate audit exposure.

Upcoding Detection
Compliance Risk Scoring
Audit Trigger Identification
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Lumi Ledger

Finance Director

Quantifies revenue at risk from undercoding and models the reimbursement impact of documentation improvements.

Revenue Leakage Quantification
DRG Revenue Modeling
Cost-to-Revenue Analysis
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How It Works

Analyze CDI effectiveness, detect undercoding and DRG discrepancies, and audit coding compliance. Surface opportunities to improve documentation accuracy and reduce compliance risk.

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Drag and drop your CSVs. No complex pipelines required.

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Lumina Analyst
Why are Blue Cross denials increasing?

Denials for 'Medical Necessity' (Code 50) have spiked 40% this month. The majority are linked to Procedure Code 99214 (Level 4 Office Visit).

Denial Reason Pareto
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Related Capabilities

CDI analyticsDRG optimizationcharge capture softwarecoding compliance auditundercoding detection