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11 March 2019 - 14:43, by , in Acute, Blog, Comments off
The health care industry has experienced significant change in the past decade. The pace of change is breathtaking! Organizations have grown and consolidated by acquiring hospitals, service lines and physician groups. Many organizations are now faced with the burden of standardizing their operations.
14 February 2019 - 12:03, by , in Acute, Blog, Comments off
The Office of Inspector General (OIG) is reviewing payments under the Post Acute Transfer (PACT) policy again. Why? The OIG wants to ensure claims are properly paid by the MACs with the controls they have put into place through claim editing. The OIGs follow-up will determine whether
Revenue Cycle Internal Audit
11 December 2018 - 15:50, by , in Acute, Blog, Comments off
Implementing a comprehensive internal audit program will position a facility to actively respond to the ever-changing healthcare regulatory environment. Achieving effective and compliant healthcare functions cannot occur without well-defined and ongoing compliance auditing.
UR Recovers 1.8M in Revenue
29 August 2018 - 12:57, by , in Acute, Blog, Comments off
The Utilization Review (UR) function in the emergency department (ED) serves as a critical component to ensure whether a patient is placed as inpatient or observation. Establishing the UR team to manage patient status at the point of admission is imperative to minimizing denials down the line. Too often, hospitals waste time and money by...
Revenue Integrity
11 April 2018 - 12:24, by , in Acute, Blog, Comments off
Revenue Integrity is needed by providers to improve revenues and ensure regulatory and contractual compliance. A proactive approach that focuses on rapid assessment and mitigation of risks to your revenue stream should be the objective of organizations. Here are several thoughts on what to consider in your approach...
Utilization Review
26 March 2018 - 12:07, by , in Acute, Blog, Comments off
Centralizing Utilization Review Functions is a cost-saving quality improvement measure, closes gap in coverage due to inter-rater reliability. Many forward-thinking organizations recognize the negative financial impact of inaccurate or non-existent UR. Learn how it's worked for a large, newly formed health system...
21 December 2017 - 11:27, by , in Acute, Blog, Comments off
With little time until the 2018 Medicare OPPS final rule goes into effect, finance leaders should take action now to address the key issues that may impact their organizations both financially and operationally.
Process Improvement
29 November 2017 - 14:41, by , in Acute, Blog, Comments off
Engrain to sustain -- By taking these steps, you will engrain processes improvements into the culture of an organization and create an efficient and successful environment.
inpatient short stay
23 October 2017 - 9:00, by , in Acute, Blog, Comments off
Based on BFCC-QIO inpatient short stay reviews, Providers could be susceptible to 25 or 10 case request based on audit area and prior audit findings.
26 September 2017 - 3:23, by , in Acute, Blog, Comments off
One of the keys to making alternative payment models work is developing your provider network. Our CEO discusses aligning a strategic plan, positioning in the market, and capital needs with the right partners...