NQS Activate 360™ identified $1.7M in potentially missed trauma charges for a Northeast Level I trauma center

The Challenge

A Northeast Level I trauma center needed a systematic way to identify trauma services documented in the clinical record but missing or incorrectly represented on hospital claims.

Trauma registry, billing, and payment data lived in separate workflows, complicating encounter-level review by trauma and revenue cycle teams.

The Solution

The opportunity was to make charge-capture gaps visible across the trauma population.

The hospital implemented Activate360™, connecting trauma registry encounters with 837I institutional claims and 835 payment remittances.

The software matched encounters to claims, evaluated documented trauma services against billing rules, and surfaced potential missing or incorrect charges for review.

Cases with sufficient supporting evidence were confirmed and submitted to the hospital’s rebilling workflow. Cases requiring further validation were routed to the care team; Activate360™ did not itself change or submit hospital claims.

The Results

Activate360 reviewed 2,701 trauma cases covering a 12-month period and found: