The scope of the Revenue Integrity team is to promote proactive billing compliance with all federal, state and HSCRC regulations, improve operational efficiencies and reduce compliance risk through charge capture monitoring, assessments, interventions, education and clinical department collaboration.
Key Responsibilities:
- Provision of billing compliance education that includes HSCRC and federal regulatory guidance, charge capture workflows, and revenue reconciliation
- Proactive charge capture assessments, issue identification, and remediation
- Oversight of revenue reconciliation activities
- Management of Charge Description Master Evaluation and implementation of charge capture workflows and optimization
- Communication and collaboration across Finance Shared Services, Revenue Cycle (Patient Access, Billing & Collections, HIM, Denials), IS&T, Compliance, and Clinical Operations
- Charge capture monitoring via Key Performance Indicator reporting and work queue monitoring
- Clinical and financial system build, maintenance, testing, and support
CHARGE RECONCILIATION IMPORTANT RESOURCES:
NEW CHARGE MASTER REQUEST(S) PROCESS:
| 2. |
Assign Ticket Ownership |
Assign to CDM Team |
| 3. |
Add Owner Submitting Ticket |
Include the Requestor's (your contact) information |
| 4. |
Include Subject Line E-mail |
Include Request Summary |
| 5. |
Body of Email |
Include the following information:
- New Procedure or Supply, requested
- CPT Code
- Pricing Information
|
SERVICE LINE AND REVENUE INTEGRITY
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