by | Apr 6, 2022 | Appeal Management, Article, Health Systems & Hospitals, Utilization Management
Registered nurses perform several jobs throughout a hospital system, most commonly patient care and coding/billing procedures. So, when a hospital starts losing its nursing staff, several critical departments start lacking needed attention. Hospitals are more likely...
by | Mar 30, 2022 | Appeal Management, Article, Health Systems & Hospitals, Utilization Management
Hospitals and their nurses are still feeling the shockwave effects from the height of the COVID pandemic, specifically the increased nurse turnover rate. In 2020 and 2021, many nurses retired or left the profession to pursue different careers, and the nation was left...
by | Mar 23, 2022 | Appeal & Claim Technology, Appeal Management, Article, Health Systems & Hospitals, Revenue Integrity Consulting, Utilization Management
The Rise of Denials According to Fierce Healthcare, hospital denial rates were climbing prior to the COVID-19 pandemic, but they reached new heights as hospitals had to counter the new public health emergency. Harmony Healthcare conducted a study and received...
by | Mar 2, 2022 | Appeal Management, Article, Health Systems & Hospitals, Utilization Management
Medical Billing Reform Since 2008, the American Medical Association (AMA) has taken the lead to bring reform to the medical billing and payment system. Even amidst the COVID-19 pandemic, the AMA played a crucial role in shaping the federal response to the omnibus...
by | Feb 8, 2022 | Analytics and Reporting, Appeal Management, Article, Health Systems & Hospitals, Revenue Integrity Consulting, Utilization Management
The Importance of Root Cause Analysis Root cause analysis is an instrumental part of any revenue integrity program as it aims to prevent denials before they ever happen. Getting down to the root cause of the issue is an—almost—surefire way to avoid the initial denial....
by | Nov 16, 2021 | Appeal Management, Article, Health Systems & Hospitals, Utilization Management
Across the US, nursing shortages are close to reaching a critical level. A McKinsey survey from May 2021 reported that 22% of the nurse respondents suggested they were considering leaving their current positions driven by factors that have developed during the...
