REVENUE INTEGRITY:
MAXIMIZING COMPLIANT REIMBURSEMENT

As hospitals and health systems continue to face financial constraints resulting from a combination of the withdrawal of COVID-era financial support, chronic payer issues including late and denied payments, and an increased level of collections required from patients with higher co-pays and co-insurance, optimizing reimbursement and ensuring a maximized level of remittance is essential. From charge capture accuracy to claims audits and root cause analysis, executives responsible for revenue integrity are analyzing greater levels of data to identify and shrink revenue leakage, ultimately reducing denials, write-off’s and shortening A/R timelines, maximizing net revenue. Facing challenges including a shifting payer environment where policies and rules frequently change and are highly inconsistent to increasing compliance risks with investigations of billing and coding, to staffing resource constraints, revenue integrity executives find themselves in great need of industry collaboration and the opportunity to share best practices.