Revenue Integrity Org Chart

At saint luke s health system in kansas city missouri revenue integrity analysts pull a sample of 10 charts per provider per calendar year to conduct chart audits says sheri bayless cpc cppm director of site of service revenue cycle at saint luke s.

Revenue integrity org chart. Revenue integrity how to implement that function within the revenue cycle can be a bit of a mystery. You should also implement more progressive functions that can enhance your revenue integrity program. Many consider a strong charge integrity program the cornerstone and heartbeat of the revenue cycle. Defining revenue integrity revenue integrity can be a stand alone department initiative program or organizational structure.

Managing change education and process improvement. Road map for revenue integrity 1. Equally important are optimally functioning revenue cycle operations it is more important than ever for healthcare organizations to have. Revenue integrity brings operational efficiency.

The basis of revenue integrity is to prevent recurrence of issues that can cause revenue leakage and or compliance risk. Revenue integrity for a hospital is more than being morally upright. Without an effective charge integrity program health care providers run the risk of revenue. Discovering who owns revenue integrity it is amazing what you can.

Micky s story in 2008 micky allen was exhausted from. Creating a culture of excellence. Discovering who owns revenue integrity 2. Typically revenue integrity departments are led by an experienced senior revenue integrity leader who reports directly to the vp of revenue cycle.

Activities under revenue integrity are expected to focus more on process improvement. It can be further summarized as properly capturing charges correctly billing for services performed and ensuring prompt accurate payment. What follows is how one hospital built its own revenue integrity dynamo from scratch by repurposing available parts. Finding the right players for the team 3.

Revenue integrity activities ensure that clean complete claims go out the door that revenue capture is correct and compliant and that facilities keep the revenue they receive. On the revenue side your team needs to monitor revenue generating departments quantify missed revenue opportunities conduct denial root cause analysis with mitigation planning cdm management charge related audits and underpayment analysis. 3 methods to revive your charge integrity program. Being fully compliant in coding and billing practices also reduces the risk of costly downstream efforts such as managing external audits and even payment denials.