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...
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...
In my recent article “your audit losses begin in medical records” I discussed the role of the release of information officer in the dramatic impact that they can have upon audit losses. In this series we want to more deeply delve into how to consolidate your audit...
Your Audit Losses – Step One Of all the sites I’ve ever consulted for there is always the same pattern and posture with auditing. Some are better than others but all have divided the audit losses into generally three categories. 1. Business Office Denials 2....
