BC Advantage - 2024 Issue 6
Crafting a Comprehensive Approach to Billing Compliance
Subscribe or sign in to view the full article.
Article Overview
This article discusses current pressures on healthcare billing compliance, including increased audit activity, denials, staffing constraints, and revenue cycle strain. It outlines a broader, technology-supported approach to auditing and compliance, and includes an organizational example showing how a provider system expanded its audit program and improved coding accuracy. The piece is aimed at healthcare finance leaders, compliance teams, revenue cycle professionals, and organizations evaluating audit and denial management workflows.
Why This Topic Matters
Billing compliance is becoming more complex as payors and regulators intensify scrutiny while organizations face labor and financial constraints. The article is relevant for teams looking to modernize audit strategy, improve denial management, and align compliance operations with broader revenue integrity goals.
Article Sections
-
Disrupt the Auditing Status Quo
Discusses current audit pressures, denials trends, staffing limitations, and the need to move beyond static audit practices. Introduces the role of automation and AI in supporting a broader compliance strategy.
-
An Optimal Approach to Billing Compliance
Outlines a technology-enabled, risk-based approach to compliance that combines different audit types, data analytics, and organizational coordination. Also addresses collaboration with payors and education informed by audit findings.
-
DHR Health Achieves a 99.9% Coding Accuracy Rate
Provides an organizational example describing compliance workflow modernization, audit expansion, and reported improvements after adopting an integrated platform.
-
Benefits of Tech-Enabled RCM
Summarizes the operational value of using technology to support audit management, revenue cycle visibility, and compliance operations.
What You Will Learn
- How current audit and denial trends are affecting healthcare billing compliance
- Why risk-based auditing is being positioned as a more flexible compliance approach
- How automation and AI are being used in revenue cycle and denial management workflows
- What kinds of operational improvements organizations may seek from integrated compliance tools
- How an example health system structured its compliance modernization effort
Who Should Read This
- Healthcare finance leaders
- Revenue cycle management professionals
- Compliance officers
- Billing managers
- Coding managers
- Health system administrators
- Hospital CFOs
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com