Due to the complexity of billing, healthcare organizations should audit on a continual basis and ensure accuracy of claims following submission to payers, according to Karen Bowden, executive vice president of revenue integrity operations at Craneware, a value cycle company.
Ms. Bowden shared the following tip with Becker's Hospital Review: "The rules change, staff changes, [RCM] system changes — they all can impact quality of claims that go out. So making sure you're sending out compliant bills is everyone's mission, but it's complicated and can go wrong without any visibility from people managing those departments. If you don't look, you just don't know."
For more of Ms. Bowden's thoughts on conducting a successful RCM audit, click here.
If you would like to share your RCM best practices, please email Kelly Gooch at kgooch@beckershealthcare.com to be featured in the "RCM tip of the day" series.
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