Revenue integrity professionals need to understand how new elements in the healthcare industry, from changing regulations to advances in technology, are affecting hospital reimbursement, compliance, and other key revenue integrity priorities. They need to stay not just current but ahead of the...Read More »
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 »
Q: If a provider documents sepsis with acute kidney injury but does not explicitly link the two conditions, should they be queried to prevent the claim from being denied?Read More »
