Q&A: Identifying opportunities for expansion

Q: What areas or functions would you like to see your revenue integrity program take a bigger role in?

Jayne Hildebrand, MBA, CHFP, executive director of revenue integrity, UnityPoint Health, West Moines, Iowa: I think one area we have some opportunity in is taking the data that we get and really taking that to our payer contracting team. There’s some connection there, but it doesn’t feel nearly as robust as I feel it needs to be. I think our contract management team doesn’t always get the proper intel to really go in there and negotiate [with payers] on some of those challenges that we’re seeing. So I’d like to see a little bit more improvement in that space.

Kay Larsen, CHRI, revenue integrity senior charge assurance associate, Adventist Health Glendale, Glendale, California: I would like the revenue integrity team to be more involved with denials. We have a separate committee for that, but I would like to be more involved with that because I would like to get it at the root issue that we’re always responding to.

LeAnn Luczek, CRCP, revenue integrity director, St. Joseph’s/Chandler Health System, Savannah, Georgia: The areas I’d like to see us more involved with would be coworker cross-training or more staff level training. From a billing standpoint, we have a number of newer billers in our organization, and and understanding all of the “whys” behind what they’re doing is important. We do a tremendous amount of in-the-moment education. An enhanced training plan is in the works and that will be a great thing for the newer coworkers in the revenue cycle.

Editor's note: This Q&A was excerpted from the 2025 State of the Revenue Integrity Industry Report. Interested in more analysis of revenue integrity trends? Register for our free webinar on June 4, 1-2 p.m. Eastern.