Hospitals face constant pressure to deliver high-quality care while maintaining financial sustainability in today’s evolving healthcare landscape. Between payor scrutiny, complex regulations, and increasing denials, aligning clinical accuracy with financial performance has never been more critical.
That alignment is achieved through strong Revenue Integrity.
What Is Revenue Integrity?
Revenue Integrity is the coordinated effort that ensures hospitals’ services are accurately documented, coded, charged, and reimbursed.
It combines clinical, coding, and financial operations to safeguard revenue while maintaining compliance and transparency.
A strong program focuses on:
- Complete and accurate clinical documentation
- Compliant patient status
- Correct coding and charge capture
- Timely, compliant billing practices
- Ongoing education and performance monitoring
Revenue Integrity is not just a finance function — it’s a collaborative discipline that connects providers, CDI specialists, coders, UM nurses, case managers, denials specialists, and revenue cycle leaders around a common goal: ensuring care is accurately represented and appropriately reimbursed.
Why Hospitals Need Revenue Integrity
Hospitals today face rising denial rates, tightening margins, and growing pressure to demonstrate medical necessity and ensure compliant coding for inpatient claims. A focus on Revenue Integrity helps protect both clinical and financial performance by ensuring that every service provided is accurately documented, coded, and reimbursed.
Hospitals that prioritize Revenue Integrity gain measurable advantages:
- Financial sustainability: Prevents revenue leakage caused by documentation gaps, coding errors, and missed charges.
- Denial prevention: Through targeted pre-bill review of claims at risk to be denied. Ensure compliant capture of missed diagnosis codes to strengthen claims from the start, reducing costly appeals and rework.
- Compliance confidence: Aligns documentation and billing practices with regulatory requirements and institutional clinical standards to defend against payor denials.
- Data accuracy: Produces reliable information for forecasting, benchmarking, and strategic decisions.
- Cross-team collaboration: Connects clinical, CDI, coding, and finance teams around a shared goal- accurate representation of patient care.
With Revenue Integrity in place, hospitals can focus on what matters most: delivering quality care supported by a financially sound foundation.
The Role of Physician Advisors in Revenue Integrity
At Brundage Group, we know that Revenue Integrity starts with clinical accuracy.
Our Physician Advisors partner with hospitals to:
- Strengthen medical necessity documentation
- Support denial prevention and appeals
- Educate providers on documentation best practices
- Align CDI and coding teams for accurate and defensible claims to reduce revenue leakage
Hospitals protect reimbursement, improve compliance, and fully and accurately capture every patient’s story by integrating clinical expertise into the revenue cycle.
The Bottom Line
Revenue Integrity doesn’t just protect revenue – it preserves the integrity of care itself.
When hospitals bridge the gap between clinical reality and financial representation, they create a sustainable foundation for quality and fiscal resilience.
Partner with Brundage Group
Brundage Group helps hospitals strengthen Revenue Integrity by aligning clinical expertise with revenue cycle strategy. Our Physician Advisors and CDI experts work alongside your staff to ensure compliance with correct patient status, identify documentation gaps, reduce denials, and ensure every claim reflects the complexity of patient care your team has provided.
Preparing for the Future of Revenue Integrity
As Revenue Integrity evolves in 2026, Brundage Group helps hospitals strengthen documentation accuracy, safeguard revenue, and reduce denials through our physician-led expertise.
