The current process for reimbursing healthcare providers functions as a pay-and-chase model, meaning you get paid for services under the presumption that the provider represented the services they rendered accurately and in accordance with various regulatory requirements.  When organizations bill for services, they are reimbursed on a good-faith basis with the expectation that clinical documentation supports the services reported.  This pay-and-chase model creates a false sense of security for healthcare providers that mistakenly assume because they got paid for something means they are doing everything compliantly.  This assumption could not be further from the truth.  Just because you got paid, doesn’t mean you billed services compliantly.  This is why an effective revenue integrity process is crucial to ensuring you get paid for the work you provide compliantly.  Revenue integrity focuses on proactively getting paid accurately for the services you provide – without fear of costly and intimidating payor audits and recoupments.  Accurate and compliant coding and billing promote revenue integrity. When you bill the right codes, you receive the right payment. No more, no less.  Clinical documentation deficiencies, coding and billing errors, compliance risks, and overpayments are most often identified in post-payment audits that occur retrospectively (meaning after the services were already paid for by a third-party).  Payor Audits and Recoupments are insidious and can lead to catastrophic consequences for healthcare providers. Many healthcare organizations fail to maintain a strong revenue integrity program.  

This webinar will define revenue integrity in various contexts and examples, demonstrate how to build an effective revenue integrity program, showcase various revenue integrity initiatives, and spotlight examples of where revenue integrity made all the difference in healthcare fraud, waste, and abuse investigations, and so much more.