Pakistan, July 29 -- Revenue integrity is not a glamorous phrase. In three decades I have never once heard it quicken a pulse in a boardroom. What it describes is plain enough: the discipline of making a medical claim correct before it leaves the hospital, rather than arguing over it after a payer sends it back.

In practice, it is a sequence, and the order is everything. Eligibility is confirmed at registration, before treatment, so nobody is admitted on an assumption. Trained coders assign the diagnostic and procedure codes. The codes and the clinical notes are then read against one another before submission, so a charge the record cannot support is caught inside the building rather than outside it. The payer's own rules are applied at ...