Policies and Procedures

Use this resource as a guide on the processes that come together to form the revenue integrity cycle.

Use this sample form as a guide for notifying patients of guidelines for Medicare outpatient/observation.

Use this sample letter to notify patients of a post-discharge self-denial by the utilization review committee.

This document provides guidance on key performance indicators for denials management and revenue integrity, including calculations for denials rates and denials overturn ratios.

This sample form helps identify utilization management committee tasks and responsibilities.

This presentation provides gudiance on utilization management committee structure and accountability.

This policy is aimed at streamlining the audit process, protecting our patient’s confidentiality, ensuring prompt payment on audited accounts, and improving billing accuracy.

Use this sample policy as a guide when developing policies and procedures for late charges at your facility.