Analyzing data that comes from claim scrubber edits, return to provider edits, variances, and denials can provide insight into repetitive issues that delay the processing of a claim or lead to denials. Use these tips to improve your organization's pre-billing analysis processes.
Regular charge reconciliation is a cornerstone of complete, compliant reimbursement but is a common weak point for hospitals. Apply these tips to support clinical staff responsible for charge reconciliation and improve charge capture.
CMS recently revised the evaluation and management (E/M) coding guidelines for inpatient providers. Understand the far-reaching effects of the changes and how to ensure your organization is in compliance.
Payer audits are likely to pick up steam as the COVID-19 public health emergency expires. Experts share tips for managing audits and what types of claims payers may focus on.
Sepsis is a systemic, deleterious response to infection that can lead to severe sepsis and septic shock. Brush up on sepsis criteria and documentation and coding guidelines.
