Avoiding the Costliest Denials
Eligibility, outpatient medical necessity, and case management authorization continue to be three of the costliest denials. To avoid the negative effects of these types of denials, it is critical to implement an improvement process based on data.
Using Dashboards to Drive Better Performance
The decision support team at Baptist Health implemented a new tool that provides dashboards to monitor service line performance, profitability, and utilization.
Trending Solutions for Rising Drug Prices
Understanding the efficacy of high-cost drug across large patient populations will help providers, payers, and pharmaceutical companies to understand the value of certain drugs and offer patients their life-saving value.
3 Tips to Ensure Information Governance Success
A hospital health information director shares three strategies to help organizations form an information governance structure.
Children’s Health Raises Efficiency with Revenue Cycle Information Governance
To leverage its data assets toward population health management and other strategic goals, Children’s Health embarked on an information governance initiative that manages data throughout its lifecycle and organizationwide.
Video: Tips for Direct-to-Employer Contracts from UNC Health
Understanding the time commitment and negotiation strategies around direct-to-employer contracts are key areas for payment and reimbursement leaders to consider.
Finding a Better Way to Handle Claim Attachments
Standardizing the electronic submission of claims attachments is a hot topic in the industry as stakeholders look for ways to reduce costs.
Legal Concerns in Telemedicine
Although telemedicine provides numerous benefits, it also presents some legal and regulatory challenges. Legal and regulatory concerns can be grouped under three main categories: Licensure laws; privileges and credentials; and confidentiality, privacy, and security.
How Providence Health Optimizes Its Customer Service Contact Center
By offering flexible and competitive work options, Providence Health maintains a high-performing customer service contact center that reduces bad debt and helps patients find financial assistance.
Negotiating Maternity Care Bundles
UTHealth’s maternity bundled payment pilot encountered two challenges: developing fair and consistent quality measures and defining what services would be part of the bundle.