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Seeing the struggle to keep up with audit requests, Cedars-Sinai's Director of Revenue Integrity purchased a Government Audit Program (GAP) as part of its revenue cycle operations. All audit requests are entered into a centralized database, which includes a detailed history of every government audit affecting the organization in the past seven years, such as line item denials on second-level appeals, internal self-audits, and external audits. Each month, the revenue integrity team generates a report that includes revenue permanently saved, revenue permanently lost, and revenue still in play, or under audit.
GAP's success has led Cedars-Sinai to increase the purview of the program and the database, which now includes information on denials and high-cost drugs. Overall, by combining the database with other aspects of the organization's robust revenue integrity program, Cedars-Sinai has avoided $76 million in lost revenue.