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In this 7-part series, we will explore the tactics you can employ to build and optimize a revenue integrity team…

Financial health must be a top tier priority for today’s healthcare organizations. Faced with some of the greatest revenue challenges…

As the HHS Office of the Inspector General (OIG) ramps up scrutiny around costly high-severity level claims, conventional wisdom holds…

Prospective vs. Retrospective Audits? Our View: You Need Both

In virtually every operation there is always the tug-of-war question: Do you want it fast or do you want it…

Decrease Denials by Introducing Prospective Audits

It is not surprising that there has been an increased focus on preventing denials. The percentage of denied claims has…

Systematic Coder Audits: A Frequently Overlooked Secret to Improving Your Revenue Integrity

With tighter operating margins and shrinking reimbursement rates, you need to ensure your organization is not leaving any revenue behind,…

5 Key Metrics to Watch to Understand If Your Audit Program Is Effective

No matter what job you have, producing measurable results is an expectation. A CEO is measured by the value of…

Why You Need More Ways to Benchmark Than Just CMS Data

Medical claims and billing data is the currency that drives your audit and compliance program. The data you are generating…

5 Current Trends Shaping Revenue Integrity Adoption in Healthcare

When it comes to the financial health of today’s provider organizations, there are multiple factors converging that will continue keeping…

A Metrics Driven Approach to Improve Your Denial Department’s Productivity

The rate that medical claims are being denied is steadily increasing and it is trend that will cost your organization…

CommonSpirit Health’s Smooth Transition to MDaudit Enterprise

The continuing growth of regulatory compliance demands in the healthcare industry—and the heightened risk that accompanies it—is placing an enormous…

COVID’s Impact on Healthcare Organizations’ Revenue and Reimbursement: The Lessons We Learned

It has been more than a year since the start of COVID-19 pandemic. While it will be years before we…