Does Your Healthcare Organization Need a Revenue Integrity Program?
“Revenue Integrity” programs aren’t a new concept, yet they’re gaining popularity as healthcare organizations struggle to improve bottom lines. Preventing revenue leakage that can result from inaccurate codes, charge capture issues, improper chargemaster set-up all are contributing factors to rejected claims and opportunities for lost revenue. Many are realizing that costly rework from returned or rejected claims can be minimized with the implementation of a revenue integrity program.
At many organizations, the revenue integrity function is performed disparately and isn’t streamlined for efficiency. Having a centralized revenue integrity program or department helps decrease the loss in revenue (i.e. revenue leakage) by providing focused oversight and dedicated resources for clinicians in the revenue generating departments. Having this level of focus and resources allows organizations to work towards ensuring charges are set up properly and being captured and coded and billed accurately leading to more timely and potentially more capture of reimbursements they’re entitled to, improving the overall healthcare revenue cycle.