The "Doctor is In" for Revenue Integrity Health

The "Doctor is In" for Revenue Integrity Health

For long-term continuing care organizations, the processes put in place that impacts revenue and compliance should not be taken lightly. It is not a leap to say that a revenue integrity health status can make or break an organization. Revenue integrity has many considerable components that need to be routinely assessed to ensure ongoing appropriate and optimized revenue and compliance is intact. Components that should be assessed in a Revenue Integrity Review include coding accuracies, appropriate charge capturing, documentation, utilization, pre-admissions/admissions process, billing process, technology utilization and even partner referral relations. It is imperative for organizations that these areas operate at maximal efficiency and accuracy for revenue and compliance.

Without solid revenue integrity processes, organizations open the door for substantial risks and the outcome can be very damaging and potentially even fatal. Currently, as an example, under PDPM, improper payments from Medicare are continuing at an alarming rate. This is attributed to poor process implementation, coding inaccuracies and insufficient or missing documentation. To add insult, some organizations have implemented costly, ineffective technologies for their PDPM reimbursement that for many remain unchecked. A first step to improving revenue and compliance health is to have a complete understanding of current processes in place. This may identify areas of opportunity for improvement. 

Due to the ongoing staffing issues being experienced, it is quite understandable that many organizations do not have the ability to perform a comprehensive assessment of their revenue integrity. Yet, with so much at stake organizations cannot use this as a fait accompli and outside assistance should be seriously considered.

Microscope has the experience and expertise to provide your organization with a comprehensive Revenue Integrity Review. This Review will promote efficient and beneficial processes to assist your organization optimize revenue in a compliant manner. 

The “Doctor Is In.” Do not wait!Schedule an appointment today.

For more information, reach out to our Continuing Long-term Care Leader:

Michael F. Masse, OTR/L

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