The Importance of Clinical Expertise in A Revenue Integrity Partner
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. Clinical expertise is critical in solving clinical and coding review challenges. Look for these important qualifications when evaluating potential partners: A team of industry veteran nurses with multiple years of experience […]
Key Considerations for Outsourcing Your Revenue Cycle
Hospital systems could risk 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, and supply expenses […]
Revenue Integrity: Analyzing and Reporting
In the healthcare industry, as with an industry involving business units, it’s common to see gaps form between clinical operations, coding teams, and patient accounting. This is a universal issue and not necessarily the fault of any one system. As a best practice, revenue integrity can be used to bridge some of these naturally occurring […]
Healthcare Interoperability Benefit #3: Improved and Consistent Patient Healthcare
In final rules issued on March 9, 2020, the CMS Mandate for healthcare interoperability requires a patient to have instant access to their medical information via a third-party application. Effective July 1, 2021, convenient patient access to personal medical records as mandated by the Patient Access Rule enables patients to directly engage their own treatment […]
3 Reports You Should Be Receiving from Your Denial Management Data
Imagine a scenario where $3MM+ in claims were denied in the first quarter of the year. However, through a thorough examination of the data in just three denial management data 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. […]
Healthcare Interoperability Benefit 2: Reduced Admin Burden & Overall Healthcare Costs
Here at Advent, our expertise as a solution provider in the healthcare ecosystem is to convert clinical information to FHIR® standard and provide an open API that allows its exchange between payers and providers, effectuating efficiency and reduced administrative costs in the claims process. We understand the nuances of the healthcare claims review process and […]
Healthcare Interoperability Benefit 1: Streamlined Data Exchange Between Health Plans, Healthcare Providers, and Patients
According to a study conducted by Johns Hopkins, 44% of medical error deaths were preventable. As the CMS Mandate for healthcare interoperability approaches, the requirements come not a moment too soon for an industry lacking effective data exchange capabilities. Medicine and treatments have advanced tremendously through the years, as we’ve witnessed with the rapid development […]
Denial Management Trends for 2021
Denial Management Trends for 2021 While medical necessity remained the number one type of denials in 2021, our team has seen three additional denial management trends emerge as significant sources of denials. If your hospital or health system is experiencing any of these denials, know that there are answers and ways to prevent them from […]
5 Strategies to Help Interpret Denial Data
Data and data analysis are an integral part of denial prevention and management. In some cases, denial management teams need help identifying the important information or the trends they should be looking for. The five strategies below can help teams interpret denial data and best utilize it within the denial appeal process. 1. Analyze your […]
Clinical Expertise Overview [VIDEO]
A Strategic Partner With Clinical Expertise At Advent Health Partners, we consider ourselves a strategic partner that works as an extension of your team to provide client-specific appeal expertise, real-time reporting, and knowledgeable recommendations. What makes us unique is the diverse clinical expertise that makes us successful as subject matter experts: 95% of our nurses […]