A recent analysis revealed that the average 350 bed hospital may not be recognizing a significant amount of revenue – one key factor – denials. Is your organization assessing denials data and conducting root cause analyses? From the opportunities identified, maximizing revenue in a compliant manner? Are you regularly auditing claims? Reviewing clinical documentation? Healthcare organizations cannot risk missing revenue capture opportunities in the current environment of tightening reimbursement and increased payer scrutiny for quality.
- Conduct Pre Bill Revenue Compliance Audits – Identify current opportunities in code assignment and documentation practices, resource performance and capacity, reimbursement opportunities, and mitigate denials.
- Assess Clinical Documentation – Determine education opportunities for providers and develop efficient and effective communication methods between Clinical Documentation Improvement (CDI) and Health Information Management Staff and providers. High functioning CDI programs both inpatient and outpatient are essential.
- Educate – Mitigate denials, improve documentation and make staff more effective through continuous education!