In theory, charge-generating departments own charge reconciliation, usually with some level of support from revenue integrity. In practice, though, responsibility can get murky. Defining each department’s roles and responsibilities is a delicate art. If a policy is too strict and overly detailed...Read More »
While physician advisors (PA) and revenue integrity staff have separate roles and responsibilities, they share many of the same goals, says Anuja Mohla, DO, FACP, MBA, ACPA-C, CHCQM-PHYADV, system medical director of utilization management at ChristianaCare in Newark, Delaware....Read More »
The Office of Inspector General (OIG) released new guidance to detail key risk areas relevant to the Medicare Advantage (MA) program and provide recommendations to various parties to mitigate these risks.Read More »
Governmental audits are handled differently at every facility, but favorable results are more likely with a strong audit response that meets all ADR requirements.
“It is imperative that organizations determine who the right folks are to engage in the process,” says Diane Weiss,...Read More »
