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Connecting clinical with financial: RAC audit follow-up

Catherine Boerner ( President of Boerner Consulting LLC New Berlin, WI.

For more than 20 years I have been saying the reason we have compliance programs in healthcare is because there was a disconnect between the clinical side and the financial side of providing healthcare. I don’t have to tell you that the financial, billing, and coding side is complicated and ever changing. The clinical folks are focused on treating their patients and providing medically necessary care in a quality manner—“Do no harm.” The clinical side needs revenue integrity, patient financial services, clinical documentation improvement, coding, health information management, finance, health information technology, and so on to help it succeed in getting reimbursed for the care it provides in a compliant manner.

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