by | Feb 20, 2024 | Appeal Management, Article, Health Systems & Hospitals, Revenue Integrity Consulting, Utilization Management
As the volume of denials continues to increase, hospitals and health systems need a more proactive approach to denial management and prevention. Providers are encouraged to move from a denial management framework to a denial prevention framework to capture appropriate...
by | Feb 20, 2024 | Analytics and Reporting, Appeal Management, Article, Health Systems & Hospitals, Revenue Integrity Consulting, Utilization Management
A hospital’s denial issues vary based on the organization, and because of this, sometimes pinpointing potential denials can be difficult. Moving from a management to a prevention model is a slow process, and issues can potentially arise if denials by the department...
by | Feb 13, 2024 | Appeal & Claim Technology, Appeal Management, Article, Health Systems & Hospitals, Revenue Integrity Consulting, Utilization Management
For the past few years, Medicare has been testing out new ways to bundle claims. The goal of this bundled claim switch is to improve care and reduce costs. A few apparent benefits in the bundled claims model have already been tested. One is simplifying the billing...
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...
