NAHRI Quarterly Call: Downtime-proofing your revenue integrity department

Wednesday, May 4, 2022

NAHRI members caught up with association updates, news, and more on the April 26 NAHRI members-only Quarterly Call.

The call kicked off with NAHRI Director Nicole Votta discussing the latest NAHRI news.

The 2022 Revenue Integrity Symposium (RIS) will be held at the Hilton Phoenix Resort at the Peak in Phoenix, Arizona, September 19–20. As we reconnect, RIS provides crucial opportunities to engage with like-minded peers across the healthcare spectrum. The event will feature the top-level educational sessions, industry-leading experts, and networking opportunities attendees have come to expect from RIS.

NAHRI is also offering the on-demand version of two virtual conferences that took place earlier this year.

Mastering Utilization Review and Patient Status: A NAHRI Virtual Event covered the intersection of utilization review and revenue integrity. The event dove into hot topics including inpatient-only list compliance, Medicare’s rules for observation services, Medicare Advantage and the 2-midnight rule, and more.

The Critical Access Hospital and Rural Health Clinics Reimbursement Virtual Symposium covered the latest revenue integrity strategies and solutions for critical access hospitals and rural health clinic teams. Expert speakers shared tips for managing Medicare policies, optimize coding and documentation, and ensuring complete and compliant revenue.

The 2022 Revenue Integrity Week is just around the corner, taking place June 6-10. This will be a week to recognize revenue integrity professionals and the valuable contributions they make to the field of healthcare. This year’s theme is The Art of Revenue Integrity. The 2022 toolkit is available on the NAHRI site now, where supplies such as logos, banners, and games can be downloaded.

You can give your colleagues a shout-out during Revenue Integrity Week to thank them for their hard work in the field of revenue integrity through NAHRI’s Peer Recognition Program. Nominate your peers at Nominators and nominees will be entered into a drawing, and the winners will be announced during Revenue Integrity Week. See the official contest rules here.

Lastly, NAHRI has moved to a new testing partner for the CHRI exam, Prometric. Prometric allows examinees the option to take the CHRI exam at a computer-based testing center or via remote online proctoring.

Revenue integrity downtime preparedness

Then, NAHRI Advisory Board member Katrina Howard-Rife, director of revenue cycle support at Eskenazi Health, a 330-bed community hospital in Indianapolis, Indiana, discussed how to prepare revenue integrity teams for a system downtime. After experiencing one in her own network, Howard-Rife has learned important lessons on how to recover.

The first lesson she shared is to expect manual processes. She explained that it was as if every computer was broken at once in her facility.

“We had to get on the floor with the nurses and really read those charts. So prepare for paper,” Howard-Rife said. “And I know it goes against everything that we’ve all learned, but start today. Print off paper that you may need in the event of a downtime.”

The second lesson is to maintain charge sheets by creating a charge sheet mechanism. It was particularly challenging to manage the behavioral health, independent diagnostic testing facility, and nursing and professional charges. Create paper charge sheet templates that include all the data you would need to capture during a downtime event and include these documents in your downtime policy. Then, update and print out the documents on a quarterly basis. This way, you can have guidance ready to give to risk assessment and disaster teams.

Have a process for collecting, logging, and copying charge sheets was the third lesson Howard-Rife shared. Providers should be dropping charge sheets off to a specified location daily and maintaining copies.

The fourth lesson is to assign key roles to team members for communication, paper control, and data logging. “A well-organized team is what’s going to save you in this case,” she said.

For the fifth lesson, ensure you have a professional charge coding process that involves proper documentation.

“Documentation is so critical to what we charge,” she explained. “We have to know that the service was performed before we’ll drop a charge. We can’t assume that the physician knows. Legible documentation is key.”

The sixth lesson is to reconcile your downtime charges. Prepare ahead of time through spreadsheets and charge receipts, Howard-Rife advises. Performing gross charge comparison can be helpful in this process.

And lastly, double check your charges.

“Here’s my call to action for you,” said Howard-Rife. “Prepare now. Get those policies, those forms, [and] those people in line.”

A recording of the April Quarterly Call is available for NAHRI members. Listening to or presenting on Quarterly Calls awards one CHRI CEU. Register now for our 2022 series of calls. If you’d like to present on an upcoming call, please contact NAHRI at