Revenue Integrity Policy And Procedures

The team must also help ensure regulatory compliance prevent revenue loss and conduct root cause analysis that minimizes scrutiny of your charge capture and cdm process from external entities.

Revenue integrity policy and procedures. The basics of charge capture coding and. And revenue integrity is the future. The next big challenge for the department is denials management which is currently managed by pfs. Policy and procedures updated or created.

Keeping up with legal and contractual compliance which is ever changing and therefore very complex by nature is not easy and requires every employee s support. Internal audit process what documents are being reviewed when. Medicaid integrity contractors mic s private payers bcbs aetna workers comp. That still doesn t help much.

Refining it to revenue integrity in healthcare narrows it down to 380 000 results. Google the term revenue integrity and you get 790 000 results. The fact is there isn t one universally accepted definition of the term. Stakeholders in revenue integrity need to set a north star in terms of core values and policy then as new challenges to revenue integrity arise they should discuss root causes define initiatives to address the challenges and later evaluate how effective the initiatives are at meeting and eventually raising the bar.