Strategic and programmatic approach to transform team performance
Align critical metrics to your revenue goals
Proprietary data-driven review program to optimize patient admission status
We defend your patient care choices to secure fair reimbursement
Root-cause analysis and strategy to combat payer tactics
Hospitals Race to Keep Pace as Payers and AI Reshape Denials Hospitals Race to Keep Pace as Payers and AI Reshape Denials Denials have become one of the defining pressure points in healthcare finance. Across hospitals and health systems, claims teams are balancing...
Medical Coding’s AI Moment Has Arrived How Medical Coding Automation Is Reshaping Revenue Cycle Performance Despite the attention surrounding AI in healthcare, much of medical coding automation still relies on highly manual workflows. Coders continue to work through...
Hospitals Can’t Afford to Treat Self-Pay as an Afterthought Where a patient chooses to seek care is no longer shaped by clinical reputation alone. Financial experience, from the first price estimate to the final statement, now factors into that decision. For...
Let’s talk about denials, a frequent and often unpleasant topic in Utilization Management (UM). One of the core beliefs of most UM teams is that denials are bad, and most of UM teams’ efforts are spent trying to prevent or reduce denials. You may have even purchased...
There is still a lot of confusion regarding the impact on Medicare beneficiaries from eliminating the Inpatient-Only List. As recent as last week, an article from The Washington Post titled New cost-cutting Medicare rule may add costs to patients, discussed how this...
By Joseph Zebrowitz, MD Denials Are Bad…Maybe Not One of the central tenets of utilization management is that “denials are bad.” Our hospitals have developed a myriad of Key Performance Indicators (KPIs) that reflect this: we track denial rate and total number of...
