by Christopher Baggot | Jul 9, 2019 | Aetna, Audits, CCMA, Claims, DRG Validation, Healthcare, HEDIS, Hospital Audits, Medicaid, Medical Records, RAC Audits, Revenue Cycle
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...
by Christopher Baggot | Jun 26, 2019 | Audits, HEDIS, Hospital Audits, RAC Audits
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...
by Christopher Baggot | Nov 9, 2018 | Audits, Claims, DRG Validation, Hospital Audits
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...
by Christopher Baggot | Oct 23, 2018 | Audits, Claims, HEDIS, Hospital Audits, Medicaid, Medical Records, RAC Audits, Revenue Cycle
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...
by Christopher Baggot | Sep 25, 2018 | Audits, Claims, DRG Validation, Hospital Audits, RAC Audits, Revenue Cycle
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...
by Christopher Baggot | Sep 13, 2018 | Aetna, Audits, CCMA, Medicaid, RAC Audits, Uncategorized
The Medical Audit Common Reviews and their Risk The Healthcare Industry (both Payers and Providers) has always had a measure of audits and their “ripple effect” carries down the line whether it be workload i.e. record retrieval, desk auditing, refund request, data...
