When organizations receive a charge denial from a commercial payer, they must weigh their options to determine whether challenging the decision will be worthwhile.
The first step is identifying the basis of the denial. If the organization can’t determine the payer’s reasoning by reviewing...Read More »
CMS is proposing a 2.4% increase in operating payments for acute care hospitals and weighing numerous modifications to quality and reporting programs tied to reimbursement.Read More »
Emergency department (ED) charges are the least likely to be entered by clinical staff or triggered by clinical documentation, according to the preliminary results of the 2025 State of the Revenue Integrity Industry Survey. The survey, which collects information on revenue integrity processes,...Read More »
