Home/Tag: Care Management

Utilization Review Program Recovers $1.8M in Revenue

2019-12-04T15:34:41-05:00Categories: Blog, Health System, Hospital|Tags: , , |

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 overlooking [...]

Utilization Management Engagement Recovers $1.8M in Additional Revenue in the First 90 Days

2020-01-03T13:46:46-05:00Categories: Case Studies, Health System|Tags: , , |

By implementing improved processes, physician and staff education, tailored operations strategies and increased admission reviews, this engagement slashed observation rates by a third. As a result of working with utilization review staff to achieve correct patient status assignments, the health system experienced a $1.8M revenue improvement in the first three months of the engagement.

Reasons to Centralize Utilization Review Functions

2019-12-04T15:36:00-05:00Categories: Blog, Health System, Hospital|Tags: , , |

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...

BFCC-QIO Inpatient Short Stay Reviews Resume with New Requirements

2017-10-23T15:08:06-05:00Categories: Acute, Blog|Tags: , , , , , |

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.