Identifying the value of a revenue integrity department

Q: What is the value of a dedicated revenue integrity department?

Kelly Bowley, RN, MBA, CRCE, senior director of healthcare business transformation, revenue cycle, at FTI Consulting in Washington, D.C.: Having a dedicated revenue integrity department allows you to create standardization and consistency so that the processes and policies, and even how you address situations, whether it be edits or other things, permits you to have more control. It allows you to make sure that [resolutions] are being applied consistently across the organization, as opposed to having certain functions

be dispersed across the organization, maybe sitting with individuals who may not report through the revenue integrity department.

Loretta Hefley, MHA, COC, CHFP system director of revenue integrity at Baptist Health System in Little Rock, Arkansas: Our revenue integrity department is small, but we're growing. We do audits. We do [charge] reconciliation. We do a lot of training with departments on reconciliation and appropriate charge capture. We are moving towards adding outpatient clinical documentation integrity to my team, which is something new for us. It is definitely a value finding missing charges and adding revenue for the health system.

Editor’s note: This article was excerpted from the 2024 State of the Revenue Integrity Industry Survey Report. Read the full report here.