In an environment of reduced reimbursement and decreasing volumes, the goal of any Revenue Integrity Program is to ensure that all appropriate revenue is captured. We will explore reasons that cause missed revenue, for example: incorrect codes on claims, missing codes, inconsistent assignment of CPT codes, inaccurate pricing of supplies that do not cover costs, and lack of communication between clinical and financial staff. This webinar will also explore the targeted components of focused Revenue Integrity Reviews, including claim reviews, clinical documentation, pricing of services and supplies, charge master, and compliance.
During this webinar we discussed:
- Identify charge capture opportunities based on unique payer requirements
- Identify margin improvement opportunities
- Establish a rational pricing methodology in the era of transparency
- How data sharing can help physicians and clinicians improve clinical documentation that is required to defend medical necessity denial