Denial Management

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Margin Pressures in Modern Healthcare: Optimizing the Revenue Cycle to Ensure System Sustainability

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Margin Pressures in Modern Healthcare: Optimizing the Revenue Cycle to Ensure System Sustainability

The US healthcare industry is making a definite shift towards value-based care, where the quality of healthcare delivered to patients and the results achieved take center stage, marking a clear departure from the traditional fee-for-servicess approach.

Resolving Medical Necessity Denials - Role of Coding and Clinical Documentation

Resolving Medical Necessity Denials - Role of Coding and Clinical Documentation

Providers may come across varying degrees of medical necessity denials on their reimbursement claims, based on the payers and the plans they work with.

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Implementing Best Practices in Patient Access Services to Improve the Patient Experience

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Implementing Best Practices in Patient Access Services to Improve the Patient Experience

Patient access services can improve the patient experience by providing clear information, streamlining registration and scheduling processes, and using technology to enhance communication and engagement. By addressing financial concerns and meeting the needs of diverse patient populations, patient satisfaction can be improved.

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The Great Resignation - Why Hospital CFOs must refocus on the revenue cycle to Survive

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The Great Resignation - Why Hospital CFOs must refocus on the revenue cycle to Survive

Coming on the heels of the pandemic, an estimated 5 million US Workers have switched to new careers during the great resignation. The healthcare sector is one of the most affected, with the COVID-19 pandemic taking a toll on the frontline workers, i.e., physicians, nurses, and support personnel.

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Six Aspects of an Effective Denial Prevention Program

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Six Aspects of an Effective Denial Prevention Program

Increasing claim write-offs and decreasing success in denial appeals amplify the already sad state of the financials of hospitals and healthcare systems caused by the current labor shortage and trend of declining reimbursements. Shouldn't hospitals be focusing on denial prevention rather than denial recovery? Here are six tips to help you get ahead in the denials game and recover more revenue.

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Don't be in Denial - Strategies to improve Cashflow from your hospital A/R

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Don't be in Denial - Strategies to improve Cashflow from your hospital A/R

From scheduling patient appointments to denial resolution, each step in the revenue cycle must ensure data integrity to avoid claim denials and rework. This whitepaper looks at some of the strategies you can adopt to create value from your revenue cycle.