Despite investments in both technology and people, clean claim submission that reflects optimized compliant revenue capture still eludes most healthcare organizations. This...

With thousands of Medicare patients discharged to post-acute care facilities annually, hospitals need to identify claims that failed to transfer under Medicare’s Post-Acute Care Transfer rules....

Optimized financial performance starts with accurately coded claims, yet far too many providers only review a small portion of cases prior to billing. This means the majority of the issues behind revenue leakage...

In order to advance patient care and process improvement, the flagship facilities of a major health network - a 415-bed hospital and 243-bed secondary facility - utilized...

With constantly changing charge items and regulations, healthcare providers need an accurate and compliant source of truth that generates correct charges and defensible pricing. A well designed and maintained CDM...

Chargemasters is more than just CPT® and HCPCS codes. It’s a key part of processes across departments, and its data can help a hospital develop insights into its operations.

To keep the chargemaster in top shape, don’t stop at CPT/ HCPCS code updates. An effective chargemaster governance...

Healthcare organizations are looking for better ways to stem the flow of denials, which have been even more challenging to manage in the last year and a half. The pandemic triggered a significant shift to virtual care services and many other changes that impacted billing, claims, and coding...

Denials management continues to be a significant challenge for healthcare organizations in 2021, made worse by the pandemic. Recently, NAHRI conducted a survey to its Council on denials management, and 100 leaders...

To improve financial performance across the enterprise, many providers are taking a novel approach: Pre-Bill Revenue Integrity as a Service, which combines automated pre-bill analysis with revenue integrity expertise. This flexible approach offers many benefits over the traditional approach of...

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