Policies & Procedures

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

Use this sample form as an organizational guide for structuring your revenue integrity department.

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

Use this sample form as a guide for notifying doctors of a Medicare inpatient to outpatient change.

Use this sample form as a guide for notifying patients of a Medicare outpatient status change.

This sample business plan is designed to help you identify key objectives and components of your revenue integrity program.

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 chart outlines the components of revenue integrity and can help make your revenue integrity program a high reliability system improving margins and patient satisfaction.

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