Building Blocks to a Successful Revenue Integrity Program

According to industry experts and research, 68%* of organizations that implemented a new revenue integrity department increased net collections and gross revenue capture.

Alignment between health system CFOs, Revenue Cycle, Physician, Compliance and Operational leadership is critical to successfully launch or enhance a Revenue Integrity strategy and program.  Leveraging outside experts who have designed, implemented and built Revenue Integrity programs inside complex delivery systems can balance the organizational drive to increase revenue with the imperative to comply with legal and contractual rules.

Partnerships with health system leadership can assist in creating a strategy, defining an achievable plan to optimize your existing Revenue Integrity program or implement a program that mitigates risk to revenue – ensuring compliance, leveraging existing coding/charge capture tools and technology, and creating a sustainable model to embrace both fee for service and value-based care reimbursement models.

Below are 7 Key Steps to Consider When Building Your Revenue Integrity Program

  1. Obtain buy-in with Executive Leadership, Compliance, IT, CMIO, Clinical Operations
  2. Leverage data and analytics to identify Areas of Opportunity, ROI & Accountability
  3. Identify Revenue Integrity Team Leader (+Manager, Staff & Physician Advocate) and Identify key roles, responsibilities and job descriptions
  4. Align to Other Revenue Cycle Performance Improvement Projects
    • Revenue Cycle Liaison Program to Clinical Departments
    • Clinical Documentation Improvement and System Upgrades
    • Denials Management
  5. Define Revenue Integrity structure, stakeholders and governance
  6. Select tools to monitor performance (staff & financial gains)
  7. Finalize annual Revenue Integrity Work-Plan

Need assistance in building or enhancing your Revenue Integrity program? We welcome you to contact us today to learn more about our Revenue Cycle strategies, Interim Leadership and our proven successful results by emailing our team at oursolutions@roundtablehit.com.

 

*Becker’s Hospital Review, October 4, 2017

2018-05-03T11:10:39+00:00 April 12th, 2018|Revenue Cycle|