by Alba Kuqi, MD, MSHIM, RHIA, CCM, CRCR, CICA, CSMC, CSAF, CCS, CCDS, CDIP
Managing claim denials is essential for healthcare organizations to maintain financial health and operational efficiency. Rising denial rates, particularly for medical necessity claims, are leading to...Read More »
CMS issued a final rule to establish several new appeals processes for Medicare beneficiaries who want to challenge a hospital’s decision to reclassify their status.Read More »
Healthcare organizations are submitting more prior authorization requests to Medicare Advantage (MA) plans than they once were, and more of their requests are getting denied, according to a recent...Read More »
Revenue integrity leaders looking to make an impact on the professional fee side of their organizations need to understand the unique opportunities and challenges of a professional fee revenue integrity program, as well as the special coding, billing, and reimbursement rules. To make the case to...Read More »
Kimberly A. Hoy, JD, CPC, discusses how her session at the 2024 Revenue Integrity Symposium will help organizations fight back against improper Medicare Advantage denials.Read More »
