Pakistan, Aug. 19 -- Everyone agrees money is best protected before it moves. Fewer agree on what should stand at the door. Revenue integrity is not a department or an annual audit. It is a sequence of tests every claim passes on its way to payment. There are five.

The first is a single rail: claims must arrive through one standardised channel, or nothing downstream can read them. The second is identity and eligibility, confirmed at admission, not reconstructed later. The third is clinical plausibility: does the diagnosis support the procedure billed, and does the coding hold together. The fourth is a behavioural baseline for every provider - what this hospital normally does - so outliers surface early. The fifth is human adjudication wi...