For years, hospitals could afford to treat the chargemaster as a technical file maintained somewhere in the background. That is becoming much harder to defend. The hospital chargemaster now sits underneath claims, contract modeling, public price files, and...
Your Denials Already Know Which Claims Need a Second Look: Five Ways to Strengthen Pre-Bill CDI If a payer’s medical director reviewed the claim tomorrow, would the record support what was billed? Denials are part of the reality for hospitals, even those with strong...
One of the most consequential decisions in a hospital can happen before a patient reaches the floor: whether the stay should be classified as observation or inpatient. This observation vs. inpatient decision can change reimbursement by thousands of dollars, even when...
