Denial prevention has become a paramount focus within healthcare revenue cycles, as the financial toll of claim denials continues to rise. The increasing use of artificial intelligence (AI) by payers has further exacerbated this challenge. To mitigate these losses, a strategic shift is necessary, transitioning from a reactive approach of managing denials post-occurrence to a […]
Embrace the Denial Management Makeover and discover how to improve cash flow, streamline billing, and finally conquer denied claims. There are few things worse than denies for any healthcare provider. They disrupt patient care, but they also add to their financial burden. Denied claims mean lost revenue, impacting your cash flow and making it hard […]
Denials within the realm of healthcare persist as a perpetual and escalating issue. By 2022, denials constituted over 11% of claims, posing a significant threat if left unaddressed, as they can severely compromise an institution’s financial well-being and prospects. The combination of outdated technology and manual processes exacerbates the burden on staff, time, and finances […]
Typical CDI programs are intended to drive reimbursement through diagnosis securement, contributing to improved case mix index. The COVID-19 pandemic is placing monumental financial stressors upon hospitals, with added costs to treat patients with high acuity and long length of stays, coupled with significant revenue loss associated with postponement of more profitable elective surgeries, […]
Value based payment models are undoubtedly the future of health care. The number of commercial and governmental ACO contracts alone increased by an average of 63% annually from Q1 2011 to Q1 2018, according to a Muhlestein et al. analysis of Leavitt Partners’ data. Though commercial payers have been slower to adopt other models that […]