Revenue integrity leaders connect to share solutions and insight

Wednesday, October 19, 2022

Hospitals and health systems are under intense pressure. They’ve experienced some of the worst margins since the start of the COVID-19 pandemic over the past several months, according to Kaufman Hall’s National Hospital Flash Report. Rising expenses and shrinking outpatient volumes whittled away at already low revenue.

In this environment, revenue integrity and revenue cycle leaders need all the help they can get. Homing in on missed revenue opportunities, tightening compliance efforts, and making smart use of available resources can help shore up revenue, but that’s sometimes easier said than done. With competing demands and fewer resources, it can be difficult to see a way forward.

For members of the NAHRI Leadership Council, enhanced research and networking opportunities have opened the door to fresh perspectives and practical solutions. The NAHRI Leadership Council is the platform revenue integrity leaders need to remain on the cutting edge of revenue integrity thought leadership and strategy. Through focused research reports, customized analysis, and peer-to-peer networking, the Council acts as a sounding board for revenue integrity leaders who seek to stay up to date with current trends in hospital reimbursement while blazing new paths for an ever-evolving industry. The Council offers a deep dive into the daily challenges of revenue integrity leadership by bringing select members of the community together to educate one another and share actionable strategies aimed at improving workflow and securing buy-in from decision-makers.

The NAHRI Leadership Council was formed in 2020 and served as a crucial resource for revenue integrity and revenue cycle leaders in the first year of the COVID-19 pandemic. During the 2020–2021 term, the Council put its primary research focus on denials. A research survey and a series of roundtable discussions culminated in a series of white papers that analyzed current challenges and explored best practices for reducing and managing denials. In 2022, the Council’s research dove into claim edits, identifying strategies for managing custom edits, best practices for workflows, and opportunities to apply claim edit data to solve upstream issues and monitor payer contract performance.

Council members also addressed other hot topics, including revenue integrity program structure, prior authorization, denials management, and charge reconciliation, and used Council networking and education opportunities to develop and share solutions.

The NAHRI Leadership Council fosters collaboration and networking through its monthly e-newsletter, topic-specific discussion groups, quarterly meetings, and a dedicated forum.

Revenue integrity and revenue cycle leaders are invited to apply for the 2023 NAHRI Leadership Council term. Applicants should be directly employed by a healthcare provider organization and have a title of supervisor, manager, director, or higher. Read more about eligibility and participation requirements here.

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Revenue Integrity