Revenue integrity: Appreciating the who behind it

Monday, June 3, 2019

by Kim Yelton, RHIA, CCS, CDIP

Today kicks off Revenue Integrity Week, a national week of recognition for revenue integrity professionals. So I would like this article to be about YOU, the WHO behind the revenue integrity profession. Revenue integrity by name is still new to many organizations, although maintaining the integrity of charges and reimbursement has been in place for years. As revenue integrity continues to grow, there are a multitude of many professions becoming under the umbrella: nurse auditors, clinical documentation improvement/integrity, revenue integrity coding, reporting, and denials/avoidable write-offs just to name a few. Some of these individuals come from clinical backgrounds or areas, health information management, revenue cycle, or compliance, and reflect the multidisciplinary effort that goes into revenue integrity.

The success of a revenue integrity department is based on the individuals who work under that umbrella. I believe in the saying, “You are only as good as those around you.” When I transitioned to head WakeMed Health and Hospital’s first revenue integrity department, I started with a staff of one: myself. It was a big challenge, but also a great adventure. I had a clean slate and support from the organization to fulfill my vision for the department. I now have a staff of 36 consisting of clinical documentation improvement/integrity specialists, charge capture analysts, charge description master coordinator, revenue integrity analysts, clinical nurse auditors and analysts, revenue integrity coders, and three managers.

When choosing individuals for these positions, it was important to realize that everyone had different strengths and knowledge. A team needs to be formed by bringing all those strengths and knowledge together to form a dynamic department. No one knows everything, so it is important to look for strengths where you have weaknesses. Once individuals are in place and understand their role, it is just as important to cross-train staff. I always say if someone wins the lottery, we will still need to maintain our workflow.

I greatly respect and support my team and all the knowledge they bring to the table. It is them and all of YOU who have transitioned to revenue integrity that makes this profession a growing opportunity. With the support of NAHRI, revenue integrity professionals can now connect with each other through forums, local chapters, live events, and other networking opportunities. Members can take an active role in leading and shaping the profession and the association by participating in a variety of committees. And, revenue integrity professionals can now demonstrate their expertise with NAHRI’s Certification in Healthcare Revenue Integrity (CHRI) credential. I was lucky enough to sit on the CHRI committee, so I also encourage you to sit for the certification and obtain this great credential. The credential will truly reflect your knowledge and expertise in this growing profession.

If you are not a member of NAHRI, I encourage you to visit and consider becoming a member. The material you could have at your fingers tips and the connections you will make are invaluable to professional growth and gives you access to a professional support network so you never have to face a revenue integrity challenge on your own.

So, happy Revenue Integrity Week to all of you. Let’s celebrate the diverse backgrounds that makes revenue integrity what it is. It truly takes a village!

Found in Categories: 
Revenue Integrity