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.
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.
As revenue integrity departments continue to evolve, facilities are often faced with the challenge of determining which tasks must fall to these departments and which are best suited for other revenue cycle roles. With so many department functions overlapping, defining revenue integrity-specific functions is a complex task.
There are two parts of maintaining correct audits: ensuring that the charges present on the claim accurately represent the care provided and documented and ensuring the claim is compliant with all applicable billing rules and regulations. One way to ease the process is to review the charges on the claim with an application or tool that can predict errors using the analytics from outpatient Medicare claim data.
Is your hospital’s chargemaster updated for 2017? Learn about the latest billing and coding changes affecting the chargemaster and how to ensure your hospital’s chargemaster is in top form to help ensure revenue integrity....
A unique organizational model has been developed to handle chargemaster and other revenue integrity workflow at Mary Rutan Hospital in Bellefontaine, Ohio; after sourcing its charge functions from throughout the organization, the hospital has created a centralized team, housed under the title of charge integrity.
Tasked with the impossible—reviewing 100% of charges before they go out the door—the revenue integrity department at Yale New Haven Health in New Haven, Connecticut, knows the importance of having a reliable staff to get the job done right.
