As hospitals transform from volume-based to value-based reimbursement, the role and functions of the utilization review (UR) committee are evolving. Learn how to refocus UR and use it as a tool for success now and in the future.
Patient matching—associating the right patient with the right medical record—isn’t a new problem, but as the practice of medicine and reimbursement models become more data-driven, the stakes will continue to rise.
Establishing an outpatient CDI program can have substantial benefits. Recently, an outpatient CDI review project demonstrated there were many documentation improvement opportunities at a large family practice/internal medicine physician clinic.
Implementing a denial avoidance initiative can help facilities and health systems realize lost revenue, achieve cost savings, and improve an organization’s financial performance.
Hospitals continue to acquire or affiliate more closely with physician practices at a breakneck speed to operate more effectively under value-based purchasing or accountable care organization reimbursement models. But many organizations struggle with how to integrate their different EHR systems, forms, and templates long after the physicians become hospital employees.
