Denials are exposing operational weaknesses that extend far beyond reimbursement, and hospitals can no longer afford to treat them as an unavoidable cost of doing business.
The Office of the Inspector General announced it is launching a new audit of evaluation and management services billed on the same day as minor procedures.
Recent data shows that health systems pulled back on acute care electronic health record (EHR) system purchasing in 2025 as part of a larger trend of organizations becoming more selective about large-scale replacement decisions.
It is no longer enough to confirm that a diagnosis is documented somewhere in the record. The documentation must also clearly demonstrate the clinical severity of the patient’s illness.
