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.
Join McBee experts as they dive into Transfer DRG audit best practices and trends, as well as provide OIG audit findings and recommendations.
Inadequate medical necessity and face-to-face (F2F) documentation are the source of many denials, and auditors will look specifically for accurate F2F and medical necessity documentation that supports the skilled services provided to patients.
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.
This 1,000 bed urban hospital was consistently denied an average of $1 million per month from third-party payers, mostly for one-day inpatient stays through the ED for which documentation reflected observation level of care.
