American Healthcare Audit Professionals, Inc.

By: Penny Jefferson, MSN, RN, CCDS, CCDS-O, CCS, CDIP, CRC, CHDA, CRCR, CPHQ, ACPA-C ICD10monitor May 18, 2026 A newly filed class-action lawsuit may be one of the clearest signals that documentation integrity has moved beyond a clinical and coding concern, and into an enterprise-level governance issue. For executive leaders, this is not simply about adopting artificial intelligence (AI). It is about how documentation technologies across a rapidly expanding vendor landsc

Understanding Missed Charges and Their Impact One of the frequent contributors to lost revenue in hospitals is the oversight of charges. Charges for supplies, devices, services, and procedures that are provided but not billed often go unnoticed. When these charges are missed, hospitals may fail to reach the required dollar amounts for outlier payments, ultimately losing valuable revenue opportunities. Establishing Proper Charging Protocols The main strategy for enhancing char

Accurate charge capture is a vital part of the healthcare revenue cycle. When healthcare organizations fail to document services properly, they risk losing millions in revenue. Beyond financial loss, poor charge capture can lead to compliance issues and increased denials from payers. To protect revenue and improve patient care, healthcare providers must focus on strong charge capture processes combined with thorough chart auditing. Why Charge Capture Matters Charge capture in

Overview of the Charge Capture Process Charge capture is a critical function in healthcare revenue management. It involves healthcare providers documenting and submitting all billable services and procedures to the billing system. When this process is not managed correctly, practices risk losing significant revenue. The Significance of Accurate Charge Capture Managing the healthcare revenue cycle with precision is essential, and charge capture is a prime example of why accura

Guidance for Leadership Growth and Team Success Becoming a better manager is a continuous process that involves developing your interpersonal skills and shifting your focus from personal achievement to the success of your team. Effective managers refine their soft skills and embrace a mindset that prioritizes collective results. Essential Management Skills Clear Communication: Establish clear expectations for each project, clearly outlining desired outcomes, timelines, and po

Importance of Medical Record Audits Quality health care relies on precise and thorough clinical documentation in the medical record. Medical record audits are a key strategy to enhance clinical documentation and strengthen the financial health of an organization. By systematically reviewing records, audits help uncover areas for improvement and ensure the quality and accuracy of documentation. Collaboration Between Coders and Clinical Staff Ideally, there should be ongoing co

Clinical Appeals With the rise in reimbursement denials over the past years, healthcare facilities are increasingly facing clinical denials. These denials are a common occurrence for providers, and while some are justified, others offer opportunities to work with providers and recover lost revenue. Denials can stem from a variety of causes, with most charging errors typically happening in the Emergency Department, Surgery, and Observation stays. Common Reasons for Denials Den