From the January/February 2022 issue of HealthCare Business News magazine
Step 4: Combine pre-bill audits with CDI initiatives for revenue acceleration and optimal impact. CDI alignment with the organization’s financial strategy including shifts in payor mix, changes in payor contracts, and adoption of new reimbursement models, is critical to optimize mid-revenue cycle performance. Furthermore, pre-bill reviews lay the foundation for building or enhancing an effective CDI physician advisor program.
Through a proactive, physician-led, and comprehensive pre-bill approach as part of the mid-revenue cycle, hospitals and health systems have the reassurance that claims are correct the first time they are submitted. They can identify the root cause of documentation and billing errors and target corrective action. They are also capable of catching potential undercharges before billing to capture revenue that may have otherwise been missed.
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Healthcare organizations can stay at the forefront of an industry that mandates fiscal responsibility and accurate quality reporting of care. The pre-bill review is the foundation for clinical integrity, revenue lift, and risk mitigation. The result is a sustainable and economically viable solution in an ever-changing healthcare environment.
About the author: James Fee MD, CCS, CCDS, is the CEO of Enjoin.
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