According to a recent press release by Craneware, an industry leader in the supply of business intelligence and revenue cycle software, like the renowned Chargemaster, more than 50% of hospital administrative executives believe that revenue integrity programs should focus on bringing the entire organization on the same page, such that accountability of the entire staff as well as a healthy mix of technology contribute equally in positively affecting the financial health of the enterprise.
Although they reckon that involving the entire organization in such an endeavor is no doubt a daunting task, they also very rightly point out that excellence cannot be achieved overnight. It requires a thorough blueprint as well as complete dedication of all the parties involved. Most staff of healthcare organizations are wary when the term “improvement program” is alluded to, and equate it to the ubiquitous and robotic six sigma initiatives. Rather than stressing on the tools of the program, they indicate that a paradigm shift in the way the participants view the whole exercise, would go a long way in ensuring the success of any such Revenue Integrity Program.
But then one may ask, what really is Revenue Integrity?? In the words of AHIMA, “It is the process of validating documentation, charges, and codes to ensure complete, compliant, and accurate billing and coding processes. A good revenue integrity team, which includes coding professionals, identifies lost charges and coding issues along with providing education and the development of processes to improve this component of the revenue cycle.”
Also central to any revenue integrity program should be the practice of perpetually re-evaluating and re-validating the fundamental principles behind every process and every system. Nothing should be taken for granted and one should not feel shy to break down any flawed system to its fundamentals and rebuild anew, so that proceeding forward they capture and identify missed revenue opportunities.
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