Revenue Integrity Coding Partners

How are you ending September?

For us, it is a time to reflect on what worked, what did not, and what patterns deserve more attention.

Better documentation.
Stronger workflows.
More meaningful audits.
Fewer preventable denials.
Closer attention to underpayments.
More education for the providers doing the work.

October is not just a new month. It is the beginning of the final quarter of the year.

That makes it a good time to look closely at what needs to be tightened, corrected, improved, or finally addressed before the year closes.

Q4 is not simply about doing more. It is about doing the right things more intentionally.

So as we close one month and enter another, the question is:

What are you leaving behind in September?
And what are you doing differently in October?

RICP | Healthcare Advisory Firm

A provider came to me because she needed help with claim submission and what she described as “billing.”

But I don’t just submit claims.

Before I could confidently send anything out the door, I needed to understand her current state.

And that review uncovered several opportunities.

I identified documentation deficiencies that could lead to denials or make the services harder to defend.

I identified coding opportunities that had been missed.

I identified undercoding that was leaving legitimate revenue on the table.

And once I looked at the full picture, the additional reimbursement opportunities I identified more than covered the cost of bringing me in.

That is the difference between completing a task and optimizing an operation.

She initially needed help submitting claims.

What she actually needed was someone who could look at the entire revenue cycle and ask:

Is the documentation supporting the work being performed?

Are we coding everything that is appropriately reportable?

Are we capturing the revenue the provider has earned?

Are we creating claims that are positioned to get paid the first time?

Are there workflow problems today that will become denials tomorrow?

That is what revenue integrity looks like.

For this provider, the result was not simply getting claims submitted.

It meant stronger documentation.
More accurate coding.
Previously missed revenue opportunities.
Fewer preventable denials.
Cleaner claims.
And a stronger revenue cycle going forward.

I don’t come in just to perform the task I was hired to do.

I look for the reason the task became necessary in the first place, identify what is being missed, and build a better process around it.

Because providers deserve to be paid appropriately for the care they provide.

Work life these days is about flexibility. It is about being able to do my best work when I am actually at my best.

For me, that is usually in the evening.

I am not a morning person. I have never been a morning person, and I finally have a life where the work I love does not always come with a strict clock-in and clock-out time. I get to give my best during the hours that work best for me, and I absolutely love that.

This week has been full. I gave two presentations, taught my ICD-10 class, worked through denials, oral surgery workflows, and claim submissions, trained new team members, and had strategy sessions focused on making sure my department continues to deliver great work.

Tonight, I am wrapping up a few Swishvo revenue cycle tasks from the couch, with my grandson right beside me, so I can enjoy my weekend away without thinking about what I left unfinished.

I am ready for the beach, good friends, rest, and a few days of forgetting about work.

I have already been warned not to take my laptop 😂

That is one promise I cannot make. I probably will not work, but I always travel with it just in case I am not back home before work starts on Monday.

This is a life I prayed for. Meaningful work. Flexibility. The ability to work from almost anywhere. Time with the people I love.

Prayer changes things. It certainly changed a lot for me.

Good night, y’all. 🙏🏽

Providers are trained to care for patients, improve outcomes, and expand access to quality care.

What they are not always trained for is everything that comes with getting paid for the care they provide.

Payer policies. Medical necessity. Documentation requirements. Coding rules. Authorization. Enrollment. Claim submission. Reimbursement requirements.

The care may be appropriate. The service may be necessary. The provider may have done everything clinically right. But getting paid still requires navigating an entirely different system.

That is where RICP comes in.

We do the research, interpret the requirements, and educate providers and organizations on what is needed to successfully bill and be reimbursed for the services they provide.

Using our Diagnose → Assess → Plan → Execute → Sustain methodology, we identify the barriers between care delivery and reimbursement, build the right process, and help organizations create workflows that can be maintained long after the immediate issue is resolved.

Because patients deserve access to quality care.

And the clinicians providing that care deserve to be paid for it.

FREE MY REVENUE.

Tonight stayed with me.

I had the privilege of presenting The Dental Crossover to the AAPC Carmel New York Local Chapter, and somewhere along the way, the room became more than an audience. It became a group of people really leaning into a conversation I care deeply about.

Hearing people say this was one of the best presentations they had attended caught me completely off guard. I actually grabbed my phone in an attempt to capture some of those words, so I could come back to them on the challenging days and remind myself that this work is reaching people.

Thank you to Mrs. Ruby and the entire officer team for inviting me, welcoming me, and giving me the space to teach something that means so much to me.

Oral healthcare is healthcare.

What happens in the mouth does not stay in the mouth. Oral health can intersect with diabetes, cardiovascular health, pregnancy, infection risk, nutrition, and so many other parts of a person’s overall health. Yet medical and dental care still too often live in separate worlds.

That is why this work matters to me.

There are patients who may have medical coverage for services related to their oral health. There are providers who want to do the right thing but were never taught how medical and dental billing connect. There are teams trying to navigate documentation, diagnosis, coding, payer rules, and reimbursement without a clear bridge between the two.

I want to help build that bridge.

Because when we understand the crossover, we are not just talking about claims. We are talking about access. We are talking about helping patients receive care they may not have known could be covered. We are talking about making sure providers have the knowledge and tools to serve them well.

This is not just something I like teaching. It is part of my purpose.

And being asked tonight if I would come back next year felt like confirmation that this conversation still has room to grow.

So yes, I’ll be back.

There is still so much more for us to talk about.