June 10, 2021

Revenue Integrity Week!

Gretchen Case

This week, Wilshire wants to acknowledge and celebrate our Revenue Integrity colleagues!   

Even though no two Revenue Integrity departments seem to be exactly alike, they are usually philosophically aligned. We live in the middle of the revenue cycle – where the clinical becomes codified and financial. Revenue Integrity professionals are the link between those worlds as well. But what do we do? That is a frequent question, and one that can be hard to answer.  Healthcare folks will always say Revenue Integrity is about chargemaster maintenance; compliant charging and billing; ensuring revenue capture and appropriate reimbursement. And they are correct, but at Wilshire, we know what our RI colleagues are doing. Especially at this time of year, the end of the fiscal year and anticipation of the beginning of the next.  You are working in endless workqueues, clearing as many accounts as possible before year end.  You are running reports and pulling data from disparate sources together to enable leadership to make informed decisions.  You are training new employees on Ambulatory workflows (because you know system functionality better than anybody else)!  You are validating upgrades to NDCs and HCPCs billing units in Willow or other pharmacy modules. You are collaborating with your OR colleagues on posting logs timely.  You are conducting chart-to-charge audits to ensure no revenue is left behind.  The list is endless. 

We know who you are and what you do, and we do commend you for it! 

At Wilshire, Revenue Integrity is also our passion and we have got some great things coming for you in the next few months that we are excited to share soon.  Check out our Revenue Integrity page to see some of the services we offer in this space.    

Gretchen Case

Managing Partner

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