Closing the Gap in Medical Necessity Review With a Clinical Documentation Integrity Registered Nurse
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Revenue cycle operations teams are responsible for maintaining reimbursement integrity and regulatory compliance across a rapidly expanding oncology service line. Increasing payer scrutiny—particularly for high-cost oncology therapies—has created significant operational strain, treatment delays, and administrative burden for providers.
In this episode, CANCER BUZZ speaks with 2026 ACCC Innovator Award winner Lacy Sheets, MBA, Director of Patient Financial Navigation at St. Luke's Cancer Institute, about her program's development and implementation of a Clinical Documentation Integrity Registered Nurse role. Embedded within revenue cycle operations, this role partners directly with physicians, financial navigators, pharmacists, and others to ensure medical necessity documentation is accurate and compliant with payer requirements.
"The whole goal of this [position] is for our patients to be treated...in a more timely fashion...and not have to worry about all of that authorization work, as well as try to eliminate that [burden for] our providers." – Lacy Sheets, MBA
Guest: Lacy Sheets, MBA
Director of Patient Financial Navigation, St. Luke's Revenue Cycle Operations
St. Luke's Regional Medical Center / St. Luke's Cancer Institute
Boise, Idaho
Resources:
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ACCC 43rd National Oncology Conference
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2026 ACCC Innovator St. Luke's Cancer Institute
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Transforming Oncology Authorization Through Clinical and Revenue Cycle Collaboration
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Optimizing Revenue Cycle Management in Oncology
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Due Diligence in Limiting Payer Denials