3 Considerations for Denial Avoidance

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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 out-of-pocket costs will be. By […]

Achieve Denial Avoidance with Revenue Integrity Consulting

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Our Strategy for Hospital Denial Avoidance – ICU Stays Learn more regarding how Advent Health Partner’s Revenue Integrity Consulting team can leverage Optics reporting, our denial management analytics delivered in drill down dashboards, to help hospitals and health systems implement denial avoidance programs. Keep reading for a specific example of our team utilizing Optics data […]

5 Tips for Healthcare Providers to Better Prevent DRG Downgrades

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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 have increased from an average of […]