End-to-End Revenue Cycle Management

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Winning the Denials Battle: How Data & Documentation Improve Reimbursement

Articles, CDI, Claims Management, Utilization Management

Winning the Denials Battle How top systems leverage data & documentation for financial and patient-centered gains Originally published on Becker's Hospital Review.With rising denial rates and increasing complexity in reimbursement processes, healthcare providers...

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Navigating CMS Price Transparency: What Hospitals Need to Know in 2025

CDI, Expert Insights, Industry Insights, Regulatory Insights, Webinars

Price Transparency in 2025: What’s Required, What’s Coming, What to Do Now July 16, 2025, 11:00 AM PST Hospitals are facing mounting expectations around price transparency. But shifting regulations, incomplete guidance, and technical complexity make compliance a...

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Aligning Payor-Provider UR Practices – Proceed with Caution!

by Dr. Joseph Zebrowitz | Mar 12, 2019 | Regulatory Insights

Over the last few years, there has been a trend toward automating the medical necessity UR screening process using software to extract clinical data and either apply commercial criteria or create an acuity score. As I have strolled across trade show floors, I see...

You Can’t Get the Right Answer if You Don’t Ask the Right Question

by Dr. Joseph Zebrowitz | Feb 19, 2019 | Regulatory Insights

In 2013, the Centers for Medicare and Medicaid Services (CMS) finalized the “Two-Midnight” Rule addressing when beneficiary hospitalizations are appropriate for inpatient payment under Medicare Part A. CMS adopted the “Two-Midnight” Rule to simplify the beneficiary...

Vulnerabilities Remain Under Medicare’s 2-Midnight Policy

by Dr. Joseph Zebrowitz | Jan 15, 2019 | Regulatory Insights

In 2016, the Office of the Inspector General (OIG) published a report, “Vulnerabilities Remain Under Medicare’s 2-Midnight Policy”, summarizing the first findings of hospital billing patterns since the implementation of the Two-Midnight Rule. The results surprised...

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