I believe that avoiding denials in the first place is the way to utilize our revenue cycle resources, especially our human resources. The more times we have to touch or rework a claim, the lower the value our final reimbursement becomes. Our goal is to get it right the first time. This can best be accomplished by education with our clinical staff in a way that they can relate and understand the general coding and billing concepts.
In the game of tug of war, will it be clinical or revenue integrity staff members who stand up to the challenge? When it comes to charge capture, it can be a struggle to know who should be held accountable.
Despite opposition from many stakeholders, a bipartisan contingent of Congress, and CMS’ own advisory panel,the agency is moving forward with its plan to drastically cut payments for drugs acquired through the 340B drug discount program, according to the 2018 OPPS final rule, released November 1.
Thank you to everyone who joined us October 23–24 at the 2017 Revenue Integrity Symposium in Franklin, Tennessee. We enjoyed connecting with current and future NAHRI members in the exhibit hall and conference sessions.
The methods for maximizing revenue capture have changed over the years. Revenue management has evolved from random chart audits to using data analytics and technology to find patterns.
