News & Analysis

August 1, 2011
HIM Briefings

Denied claims got you down? An upper-level appeal may be the answer.

December 1, 2010
HIM Briefings

You receive a RAC demand letter for repayment. But wait a minute before you pay up—you might want to take a close look to make sure your facility was really in the wrong. Karen Sagen, managed care leader at Bellin Health System in Green Bay, WI, who has worked in revenue cycle management for the past six years, has developed a step-by-step list of things to consider before pulling out your hospital’s checkbook.

September 1, 2010
HIM Briefings

According to a July HCPro survey of approximately 500 healthcare providers, 56% have already received medical record requests and 40% have had money recouped by a RAC.

July 1, 2010
Case Management Monthly

The appeal process is much more complex than conducting a clinical review for an insurance company. Appeal writers must complete a full review of the record and consider multiple sources, such as CMS guidelines and managed care contracts, to successfully argue their case.

June 1, 2010
Case Management Monthly

Denial prevention begins by establishing channels that lead to a systematic review of each patient’s admission.