Definition Of Revenue Integrity

Google the term revenue integrity and you get 790 000 results.

Definition of revenue integrity. We know revenue integrity programs are effective but there are still multiple definitions of what it is. Creating a revenue integrity definition at first glance the concept of revenue integrity may seem easy to define. Most every hospital cfo recognizes the need for revenue integrity but many hospitals are still tinkering with how ri fits into their organization. Creating a revenue integrity definition david fletcher mph a hospital that institutionalizes revenue integrity has likely prioritized an approach to coding encounters in a way that maximizes legitimate reimbursement.

The fact is there isn t one universally accepted definition of the term. Nahri s definition of revenue integrity the basis of revenue integrity is to prevent recurrence of issues that can cause revenue leakage and or compliance risks through effective efficient replicable processes and internal controls across the continuum of patient care supported by the appropriate documentation and the application of sound financial practices that are able to withstand. When a person has integrity he or she is honest and morally upright even when that requires decisions and actions that may not serve one s it has a. Defining revenue integrity revenue integrity can be a stand alone department initiative program or organizational structure.

What revenue integrity is not is having someone work the same issues every day or analyzing and benchmarking issues without a direction to improve. One thing that isn t in. The basis of revenue integrity is to prevent recurrence of issues that can cause revenue leakage and or compliance risk. Revenue integrity managers should expect coding productivity of 95 which means that only 5 of the coding load should be in the queue.

Click here to continue. The key word here is legitimate as in legally. 3 revenue reconciliation kpis information gleaned after coding and the submission of charges can reveal valuable insights. Refining it to revenue integrity in healthcare narrows it down to 380 000 results that still doesn t help much.

According to a 2017 hfma survey of 125 hospital and system financial executives 22 identified ri as the leading priority for their organizations but fewer than half of those respondents 44 have established ri programs.