Revenue Integrity 101

“Revenue Integrity” within a healthcare system means many different things depending on who you ask, the size of the institution, and if the OIG (Office of Inspector General) has paid a visit or not. I believe Revenue Integrity (RI) is a culture that lives within an organization and is part of each component of the […]

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ICD-10 Readiness Checklist

67, 66, 65, 64 days and counting…. We are officially on the FINAL countdown to ICD-10 implementation. Health systems, providers, payors, etc., are working diligently to review that “Master Task List” we all created, what seems to be, a decade ago by now. At this point, time is short and some in the healthcare industry […]

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Code Integration

Most organizations produce 1,000s of claims a day with hopes they’re compliant and will ensure proper reimbursement. Within those UBs/837Is are claim lines, which are primarily comprised of charging and coding data. The process responsible for creating those claim lines is “Code Integration.” At most organizations, this process is a black box. It happens behind […]

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