Various analyses must be conducted to maintain compliance, assist with charge capture, solve account edits, and review any possible coding trends or issues that may cause claim delays, denials, or unnecessary rework. Learn how to effectively leverage this data to improve processes and protect revenue.
A CDI program’s ability to expand is directly dependent on current resources or immediate budgeted resources. Apply these tips to guide your organization's outpatient and ambulatory CDI strategies.
The nervous system, also known as the body’s command center, controls movements, thoughts, and automatic responses to stimuli. Neurological diseases and disorders are the result of dysfunction in the brain, spinal cord, and nerves. Brush up on recent changes to these codes.
The 2023 Inpatient Prospective Payment System (IPPS) final rule includes a welcome payment rate increase, coding updates, and adjustments to quality and reporting programs. Review the major provisions of the rule to ensure your organization is in compliance.
The variety of sources for commercial insurance requirements can present challenges to the utilization review (UR) specialist, as UR rules for every patient could differ depending on his or her insurance and that insurer’s policies. Apply these lessons to help UR manage commercial insurance requirements.
Critical access hospitals (CAH) and rural health clinics (RHC) provide vital services to their communities, but even in the best of times they can face serious revenue challenges. Ensure these vital facilities are supported by correct, complete billing practices.
