UnitedHealthcare recently announced its plans to cut prior authorization requirements for 30% of services that previously required insurer approval by the end of 2026.Read More »
Gain insights into how healthcare organizations can modernize the mid-revenue cycle by integrating AI-driven insights, interdepartmental audit programs, and targeted provider education across inpatient, outpatient, and professional settings.Read More »
In theory, charge-generating departments own charge reconciliation, usually with some level of support from revenue integrity. In practice, though, responsibility can get murky. Defining each department’s roles and responsibilities is a delicate art. If a policy is too strict and overly detailed...Read More »
While physician advisors (PA) and revenue integrity staff have separate roles and responsibilities, they share many of the same goals, says Anuja Mohla, DO, FACP, MBA, ACPA-C, CHCQM-PHYADV, system medical director of utilization management at ChristianaCare in Newark, Delaware....Read More »
The Office of Inspector General (OIG) released new guidance to detail key risk areas relevant to the Medicare Advantage (MA) program and provide recommendations to various parties to mitigate these risks.Read More »
