Q&A: Choosing a revenue integrity model

Wednesday, December 15, 2021

Q: How can I determine which revenue integrity model is right for my facility?

A: There’s no one-size-fits-all revenue integrity model, and that can make choosing the right one a daunting task. To understand which model will fit you best, consider the needs and nature of your organization, said Caroline Znaniec, MBA, MS-HCA, managing director at CohnReznick. During NAHRI’s July 27 Quarterly Call, Znaniec discussed strategies for starting and fine-tuning a revenue integrity program.

When evaluating revenue integrity models, consider your organization’s:

  • Affiliation
  • Culture
  • Infrastructure
  • Service offerings
  • Type and size

 

Other internal and external factors, such as budget, must also be considered, Znaniec said.

Understanding these elements will allow you to precisely define revenue integrity’s scope and staffing needs—key to fulfilling established goals, she added. The model you choose must be the most effective one for your organization, and that choice will be different for a multihospital health system versus a sole community hospital.

Editor’s note: For more information, see “Tailor-made: Choosing the right revenue integrity program design” in the October 2021 issue of the NAHRI Journal. Find more NAHRI resources on revenue integrity program design here.