by | Oct 20, 2022 | Article, Health Systems & Hospitals, Utilization Management
An efficient denial prevention process is based on the concept of clean claims. Your clean claim rate is the differentiating factor between denial prevention and appeal management. Ensuring clean claims is critical to your bottom line. Why? Clean claims are 1:1,...
by | Aug 16, 2022 | Appeal & Claim Technology, Article, Health Systems & Hospitals
Providers today are better informed and are prepared to take on more challenges due to the information and flexibility that EMRs provide, yet this technological tool is not without its downfalls. EMRs are notoriously hard to navigate, especially when performing manual...
by | Jul 5, 2022 | Appeal Management, Article, Health Systems & Hospitals, Revenue Integrity Consulting, Utilization Management
According to U.S. Healthcare Denial Management Market, a study conducted by Research and Markets, in 2021, the U.S. healthcare denial management market size was valued at $3.57 billion. By 2027 it’s expected to grow an additional 66% and reach $5.94 billion. Denial...
by | May 19, 2022 | Appeal Management, Article, Health Systems & Hospitals, Revenue Integrity Consulting, Utilization Management
The US is currently experiencing a significant nursing shortage, and it unfortunately isn’t expected to end anytime soon. Since the start of the COVID-19 pandemic, our country’s nurses have demonstrated their dedication and heroism, highlighted in countless news...
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...
