Heightened and increasing complex payer denial activity are putting growing pressure on hospitals. With major shifts in reimbursement, and the growing costs of simply keeping the doors open and caring for patients, denials are just one more obstacle hospitals face. But fortunately, it’s one that...

Hospitals are reinventing their approach to denials to meet today’s challenges—and get ahead of future shifts in payer tactics. They know that the payer landscape has undergone a tremendous shift in recent years, with Medicare Advantage (MA) overtaking traditional Medicare in many markets and...

Leigh Poland, RHIA, CCS, CDIP, CIC, explains how to use the Office of Inspector General's (OIG) Work Plan to identify internal audit opportunities, shore up reimbursement compliance, and protect revenue.

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