The Importance of Client Success in Your Revenue Integrity Partner
Hospitals and health systems seek partnerships that provide solutions to improve revenue integrity. 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 expertise, open and consistent communication, and frequent reporting are all […]
The Importance of Technology Solutions From Your Revenue Integrity Partner
Why 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. […]
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 […]
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. […]
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 […]
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 […]
3 Considerations for Denial Avoidance
3 Considerations for Denial Avoidance Imagine a scenario where a patient needs a necessary surgery like a prostatectomy due to prostate cancer. When the provider and patient decide to move forward with the surgery, it’s essential to set a precedent by talking to both the patient and the insurance company to find out what the […]
5 Tips for Healthcare Providers to Better Prevent DRG Downgrades
Why learn to prevent DRG downgrades? The clinical downgrading of diagnosis-related groups (DRG), or DRG downgrades, has become an extremely problematic issue for healthcare providers over the past decade. Overall, denials related to DRGs are increasing; downgrading target DRGs without even requesting documentation can also happen. One healthcare system, for example, found that DRG downgrades […]