by Christopher Baggot | Jul 21, 2023 | Aetna, Audits, Blog, CCMA, Claims, Clinical Medical Necessity Appeals, DRG Validation, Healthcare, HEDIS, Hospital Audits, Medicaid, Medical Records, RAC Audits, Revenue Cycle
Adoption of Cloud-based Solutions: As healthcare data volumes continue to grow exponentially; traditional data storage and management systems often struggle to keep pace. Cloud-based solutions offer virtually unlimited storage capacities and are easily scalable to...
by Christopher Baggot | Jun 12, 2023 | Aetna, Audits, Blog, CCMA, Claims, Clinical Medical Necessity Appeals, DRG Validation, Healthcare, Hospital Audits, Medicaid, Medical Records, RAC Audits, Revenue Cycle
The world of healthcare finance is replete with numerous challenges, and one of the most daunting is denial management. The labyrinthine structure of insurance claims processing, combined with the bureaucratic red tape and inefficiencies in healthcare systems, can...
by Christopher Baggot | Jul 9, 2019 | Aetna, Audits, Blog, CCMA, Claims, DRG Validation, Healthcare, HEDIS, Hospital Audits, Medicaid, Medical Records, RAC Audits, Revenue Cycle
Passive, Proactive, and Retrospective Cost Containment in Medical Auditing A case study analysis of services supplied to our hospital/provider clients By Christopher Baggott, CEO Medlinks Cost Containment, Inc. The great boxer Jack Dempsey said, “The best defense is...
by Christopher Baggot | Sep 13, 2018 | Aetna, Audits, Blog, CCMA, Medicaid, RAC Audits
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...
by Christopher Baggot | May 12, 2015 | CCMA
Here in Reno, Nevada for the combined conference of Certification Council for Medical Auditors (CCMA) and the American Association of Medical Audit Specialists (AAMAS). I’m honored and pleased to announce that I’ve been elected President for the CCMA org. The CCMA,...
by Christopher Baggot | Feb 18, 2015 | Blog, CCMA
Effective December 4, 2014, membership in AAMAS is no longer a CMAS requirement. The Council recognizes the many relevant organizations that work with our core mission. Therefore, membership to a revenue integrity organization or quality management organization is now...