US Staffing Crisis: Nurses in High Demand

Across the US, nursing shortages are close to reaching a critical level. A McKinsey survey from May 2021 reported that 22% of the nurse respondents suggested they were considering leaving their current positions driven by factors that have developed during the pandemic. To make a bad scenario even worse, over half of these nurses are […]

4 Ways to Prevent Disallowed Charges From Bundled Claims

Prevent Disallowed Charges

For the past few years, Medicare has been testing out new ways to bundle claims. The goal of this bundled claim switch is to improve care and reduce costs. A few apparent benefits in the bundled claims model have already been tested. One is simplifying the billing process by instituting a single price for all […]

3 Things to Look for in a Revenue Integrity Partner

3 Things to Look for Revenue Integrity Partner FI

A revenue integrity partner is necessary for building a broader understanding of organizational claims processes and improvement opportunities. A strategic partner can help decrease time-to-revenue and reduce administrative costs. Finding and onboarding a partner for your revenue integrity program involves both time and resources, making it important to find the right fit from the start. […]

The Importance of Client Success in Your Revenue Integrity Partner

Revenue Integrity Partner Client Success

Hospitals and health systems seek partnerships that provide solutions to improve revenue integrity, and a partner that fosters client success is essential and allows you to manage your revenue cycle more effectively, creating a decreased time-to-money ratio. A sense of urgency, root cause analysis, subject matter expert, open and consistent communication, and frequent reporting are […]

The Importance of Technology Solutions From Your Revenue Integrity Partner

Revenue Integrity Partner Technology

One of the most important elements in a revenue integrity partnership is technology. When considering engaging a revenue integrity partner or optimizing your current strategy, a commitment to technology will be an asset to the revenue integrity management teams.  Healthcare has changed dramatically, even in the last decade, with greater access to technology. Technology enables […]

The Importance of Clinical Expertise in A Revenue Integrity Partner

Revenue Integrity Partner Clinical Expertise FI

When considering engaging a revenue integrity partner, it’s essential to focus on three main components: clinical expertise, the right technology, and proven client success, but for this article, we will focus on clinical expertise. Clinical expertise is critical in solving clinical and coding review challenges. Some important qualifications include:  Having a team of industry veteran […]

Key Considerations for Outsourcing Your Revenue Cycle

Outsourcing Revenue Cycle Management Considerations

Hospital systems could be in danger of losing $122 billion in revenue by the end of 2021. The American Hospital Association commissioned a study to examine the effects of the COVID-19 pandemic on hospital revenue. They found that hospital revenue will likely continue declining throughout 2021 to make up for the increase in drug, labor, […]

3 Reports You Should Be Receiving from Your Denial Management Data

3 Denial Management Reports FI

Imagine a scenario where $150,000 in claims were denied in the first quarter of the year. However, through a thorough examination of the data in just three reports, your team is able to implement additional training for your team, review and adjust documentation for certain payers, and adjust the coding on specific services. With these […]

[VIDEO] Trends in Denial Management for 2021

2021 Denial Management Trends Featured Image

While medical necessity remains the number one type of denials in 2021, our team has seen three additional causes emerge as significant sources of denials this year. If your hospital or health system is experiencing any of these denials, know that there are answers and ways to prevent them from occurring in the future.  1. […]