Revenue Integrity

Q. Nearly 85% of respondents hold one or more credentials. What value can credentials bring to revenue integrity professionals and the overall state of the industry?

A. Credentials are a great way to demonstrate proficiency and understanding that sets one apart from their peers. Adding a professional credential can especially aid the addition of more junior staff to a growing industry such as revenue integrity where their knowledge is obtained on the job more than a classroom. Adding a credential supports the knowledge obtained but also enforces how to translate that knowledge in a broader perspective.

Adirondack Health came to TruBridge after discovering they could save money over their previous clearinghouse. Due to the seamless integration to Meditech as well as other product capabilities, the several benefits revealed themselves.

Q: Under the introductory section of the CPT Manual’s Organ or Disease-Oriented Panels section, third paragraph, it is stated, "Do not report two or more panel codes that include any of the same constituent tests performed from the same patient collections." I am seeking clarification as to whether this literally means the same blood specimen collection or if it more generally means the same date of service (DOS) collection. In the hospital setting sometimes constituent tests are performed on the same DOS on an outpatient encounter, so it might lead one to report an applicable panel code. However, sometimes the constituents are not ordered at the same time, and the tests might be run from separate blood specimens drawn at different times, but still on the same DOS. Is there any guidance or reference that could clarify this?

Calling all Revenue Integrity Investigators! Revenue Integrity Week (June 1‒5) is just days away and NAHRI has a lot in store to ensure we all recognize the dedication of revenue integrity professionals while taking some time for education, networking, and most importantly fun.