by | Nov 3, 2022 | Analytics and Reporting, Article, Health Systems & Hospitals, Utilization Management
Following and understanding industry trends is one of the best ways to improve your revenue cycle. By nature, the healthcare industry is constantly evolving. This means that your revenue strategy won’t stand up to the test of time without optimization and...
by | Oct 27, 2022 | Article, Health Systems & Hospitals, Utilization Management
As of 2022, payer denial rates are hitting averages as high as 80%. This increase in denials severely affects hospitals by decreasing revenue and overloading staff. Why the increase in denial rates, though? Payers are rapidly gaining two things: knowledge and...
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 | 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...
