Success Stories in Revenue Integrity Achievement

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You'll Learn To:

• Identify revenue leakage gaps and gain visibility into issues that impact your organization’s revenue management, including workflow and business processes. 
• Improve the efficiency and effectiveness of processes for appropriate pricing, coding and charging for patient care services and supplies—even across disparate organizations and platforms.
• Efficiently accomplish revenue integrity initiatives using automated tools, including the effective collaboration between clinical and financial staff for assigning chargemaster access and activities to appropriate personnel.

Webcast Summary:

Managing for revenue integrity—obtaining optimal efficiency, compliance and appropriate reimbursement—is more vital than ever to the success and sustainability of healthcare provider organizations.

Yet, despite the fact that more than 50% of most hospitals’ revenue is charge-based, respondents to an April 2009 HFMA member InstaPoll indicated that more than 64% still use manual processes or consultants to update their chargemaster. And more than 96% of operational department managers only review their complete chargemaster with finance either annually or when driven by a specific event.

The success stories of three providers offer best practices for revenue integrity management:

• Sutter Health uses direct visibility into its financial administrative practices to identify and prevent revenue leakage across a wide range of disparate facilities and platforms.
• Cleveland Clinic has proven success in managing both hospital and group practice revenue integrity efforts.
• University Hospital discovered the impact of optimally monitoring pricing when a repricing of radiology charges resulted in a $1.5 million annual payment increase. 

Understanding the successful tactics used by these peers will help you further your organization’s revenue integrity initiatives.

Intended Audience:

Level:

Speakers:

Margery Mazoh
Cleveland Clinic
Director, Chargemaster & Pricing Services

Brian Patterson, RN
University Hospital
Chargemaster Coordinator, Revenue Management Department

Moderator:

Subject Category:

Financial management