Is optimizing reimbursement a bad thing?

1 minute read

Over the past 20 years, it often raised a red flag for compliance officers when they would hear the goal of a change or new initiative was to “increase revenue.” Of course, that would mean the compliance officer was at the right table to hear this plan in the first place—but that is the topic for another article.

I cringed every time I heard someone say, “This will optimize reimbursement,” and was skeptical about contingency fee arrangements. To be honest, I am still a bit skeptical because you do not want to perform initiatives that promise cost savings and increased revenue when compliance is not at the table to assist with navigating the potential pitfalls that could result. Sometimes it may just be that the team members proposing the change may simply not have the whole picture or are missing a piece of information that is critical to maintaining compliance or keeping the organization out of potential compliance trouble. It is best to be proactive and face all the angles head-on at the beginning, allow for constructive criticism, and avoid “group think” because it sounds like great cost savings and a revenue-optimizing opportunity.

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