Check out our tips from HIM expert Keith Olenik to ensure outpatient revenue integrity in a healthcare environment where merger and acquisition activities show no sign of slowing down.
- Have a multidisciplinary team.
This is critical. Cover all the bases and all the areas of expertise.
- Invest in the right technology and optimize workflows.
Technology can be your friend, but it can also do you a lot of harm. Make sure you have the right technology and the right workflows and look at that process to make sure you are not just accelerating bad processes.
- Continue ongoing training and education.
After you’ve done all this work, it does not do you any good if nobody knows how to use it. Also, turnover is inevitable. Education and training need to be core and ongoing.
- Establish medical necessity upfront.
To avoid issues with denials, this requires physician engagement, which goes back to training and education, so they know how to get that information upfront.
- Communicate about the denial and appeal process.
You can have the best process, the best people but you are still going to get denials. Make sure you can address denials to be able to capture the money that you can or solve the problem when you continue to see patterns.
Learn more about the specific technologies to consider to ensure outpatient revenue integrity in the latest episode of “Get to the Point.”