by | Jul 16, 2021 | Analytics and Reporting, Appeal Management, Article, Health Systems & Hospitals, Revenue Integrity Consulting, Utilization Management
Hospital systems could risk losing $122 billion in revenue by the end of 2021. The American Hospital Association commissioned a study to examine the effects of the COVID-19 pandemic on hospital revenue. They found that hospital revenue will likely continue declining...
by | Jun 25, 2021 | Analytics and Reporting, Appeal Management, Article, Health Systems & Hospitals, Utilization Management
Imagine a scenario where $3MM+ in claims were denied in the first quarter of the year. However, through a thorough examination of the data in just three denial management data reports, your team is able to implement additional training for your team, review and adjust...
by | Jun 16, 2021 | Analytics and Reporting, Appeal Management, Article, Health Systems & Hospitals, Provider Video, Provider Webinar Replay, Utilization Management, Video
Denial Management Trends for 2021 While medical necessity remained the number one type of denials in 2021, our team has seen three additional denial management trends emerge as significant sources of denials. If your hospital or health system is experiencing any of...
by | May 17, 2021 | Analytics and Reporting, Appeal Management, Article, Health Systems & Hospitals, Provider Video, Provider Webinar Replay, Utilization Management, Video
3 Considerations for Denial Avoidance Imagine a scenario where a patient needs a necessary surgery like a prostatectomy due to prostate cancer. When the provider and patient decide to move forward with the surgery, it’s essential to set a precedent by talking to both...
by | Mar 22, 2021 | Analytics and Reporting, Appeal Management, Article, Health Systems & Hospitals, Utilization Management
Why learn to prevent DRG downgrades? The clinical downgrading of diagnosis-related groups (DRG), or DRG downgrades, has become an extremely problematic issue for healthcare providers over the past decade. Overall, denials related to DRGs are increasing; downgrading...
