In this 7-part series, we will explore the tactics you can employ to build and optimize a revenue integrity team designed to create measurable value for your organization. You can find the other parts of the series here.
A value-generating revenue integrity team is one in which your team finds and addresses compliance and billing risk AND your team is also finding opportunities to improve revenue. Whether it be in identifying under-coded claims, reducing and addressing denials to decrease days in AR, or finding denied charges that are never resubmitted, there are often many hidden opportunities to increase revenue.
Your team should not be seen as simply a cost center, it should be seen as providing a positive impact on your organization’s revenue.
To get your team the recognition it deserves, it is critical to have a plan to show your value to both colleagues and your executive team. Typically, we see this accomplished with two regular meetings. The first one is a monthly meeting you hold with your peer teams such as revenue cycle and billing compliance. The second meeting is a quarterly meeting on the corporate level with your chief financial and medical officers and sometimes board members. During these meetings, you will want to present a visual representation of what has happened, along with a story of the trends to help reinforce and give meaning to the visuals.
A few examples of the types of reports you should be sharing include denied amount trending, the financial impact of under-coding, and trends in audit volume and risk reduction.
The Charge Analyzer and Revenue Optimizer modules of MDaudit are able to provide these reports, in addition to so many more, which help you to illustrate the value your team provides. By combining powerful images with commentary regarding the changes that made an impact, it should be easy to communicate with executives and colleagues about the powerful positive impact your revenue integrity organization provides.
