Medical Appeal Case Study Clinical Appeals Case Study Challenge The client is suffering under an “onslaught” of denials and while struggling to keep up, they also would like to understand the exact reason for the denials and their fiscal impact on the client. Solution...
Passive, Proactive, and Retrospective Cost Containment in Medical AuditingA case study analysis of services supplied to our hospital/provider clientsBy Christopher Baggott, CEO Medlinks Cost Containment, Inc. The great boxer Jack Dempsey said, “The best defense is a...
Passive Cost Containment Stopping Medical Audit Loss Before It Begins By Christopher Baggott, CEO Medlinks Cost Containment, Inc. “Passive Cost Containment” refers to the process of records request reviews. In order to reduce audit loss, the provider must...
Defense for Claim Sweeping of “Routine” Supplies Recently a hospital client asked us to review claims where the supply items had been removed from the claim. In response to the request, we found the health plan had “swept” a few particular revenue centers, claiming...
As reimbursement rules catch up, providers embrace technologies for remote care and patient monitoring. Centralized care, with a hospital as the “hub,” is the standard in the U.S. today. But this familiar model is changing rapidly, as providers embrace remote care at...
Containing clinical costs in a safe manner in hospitals is crucial in the new value-based era of care. Reducing patient lengths of stay has been one of the main targets for clinical cost containment in hospitals. One-way hospitals can contain costs is by implementing...
