Rising denials are putting unprecedented pressure on hospital and health system finances, forcing organizations to do more with less while striving to maintain high-quality patient care. Those in the CDI and revenue integrity fields are increasingly being asked to help fight the rising denial...
The OIG (Office of Inspector General) and Medicare Administrative Contractors (MACs) are heavily scrutinizing telehealth, remote patient monitoring (RPM), remote therapeutic monitoring (RTM), and communication-based services because of rapid Medicare spending growth and fraud concerns. Current...
UnitedHealthcare is fulfilling its pledge to reduce prior authorization requirements by 30% by the end of the year. Starting October 1, the insurer will no longer require approval for more than 1,700 procedure codes across various plans.
Rising denials are putting unprecedented pressure on hospital and health system finances, forcing organizations to do more with less while striving to maintain high-quality patient care. Those in the CDI and revenue integrity fields are increasingly being asked to help fight the rising denial...
As documentation requirements grow more complex and payer scrutiny continues to increase, many healthcare organizations are discovering that maintaining documentation integrity requires more than...
Denials rarely start at the payer. They often begin upstream, in the gaps between clinical, financial and quality workflows, where teams may be aligned in purpose but disconnected by process. In this fireside chat healthcare leaders...
