Utilization Management: The Importance of a Comprehensive Program
Learn the importance of a comprehensive Utilization Management process and the benefits including a decrease in denials, improved revenue and more.
Overcoming Denials and Appeals with these 5 Action Items
There are many different factors that can lead to rising audits and denials within any healthcare organization. Even when all the boxes seem to be checked, denials continue to rise. Take these five action items to expedite the appeals when faced with growing denials within your hospital or health system.
Implementing A Multifacted Approach for Strategic Denial Management Within Health Systems
There are many different factors that can lead to rising audits and denials within any healthcare organization. Even when all the boxes seem to be checked, denials continue to rise.
Top 4 Benefits of Using Interim Leaders in Healthcare
When an organization loses a key member of the management team, it creates a void that can impact care delivery and overall operations in many ways.
Emergency Preparedness Plan: Evaluating Effectiveness and Staying Compliant
The COVID-19 pandemic has reinforced the importance for healthcare organizations to have an efficient emergency preparedness plan in place. Learn the different aspects leadership should consider when developming a compliant emergency preparedness plan to lessen adverse impacts, keep business on track and keep your staff and patients safe.
Value-Based Care and Bundled Payments: What Health Systems and Payers Should Be Doing Now
The healthcare industry has faced numerous challenges in finding effective ways to achieve the triple aim through improving the patient experience, improving health of communities and reducing healthcare costs, and implementing innovative payment strategies is essential in achieving those goals.
Drug Diversion Prevention: Compliance Strategies to Mitigate Risk
The opioid crisis and hospital drug theft have been appearing more frequently in headlines for several years, making drug diversion a front-running issue in the acute space.
Charge Description Master (CDM): A critical resource, but often overlooked!
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.
Post Acute Transfer (PACT) Payment Policy – What’s New?
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