In a study of 239 hospitals under the Medicare program, Hsia et al. identified the rate of DRG coding errors to be 20.8%, of which 61.7% significantly...
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Changing laws and regulations can make it difficult for organizations to keep up with healthcare compliance and noncompliance can lead to serious cons...
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Precise clinical documentation is integral to every patient encounter, as it assists providers to make informed decisions for patient care, helps asse...
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The HCC model assigns a Risk Adjustment Factor (RAF) score to each patient basis patient’s demographics and diagnoses, which is a relative measure of...
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By virtue of ever-changing dynamics of regulatory standards in relation to compliances of DMEs, billing and reimbursement for these pose specific chal...
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October 2021 report in Becker’s hospital reviews studied $100 billion worth of denials and $2.5 billion in audited claims to assess reason why payers...
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The Change Healthcare 2020 Denials Index which is an analysis of 102 million hospital transactions valued at $407 billion in total charges across more...
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Missing or Invalid Claim Data is a significant cause of claim denial that accounts for about 17.2% of all denials. Clean claims without errors and wit...
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Incorrect payment posting affects the entire revenue cycle. If payment posting is incorrectly done by the team, the balance of the paid account still...
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“Days in AR” is the first measure of the overall performance of your accounts receivable efforts. The following figures are looked as benchmarks for m...
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A transparency data released in 2020 by the Centers for Medicare and Medicaid Services (CMS) to examine claims denials and appeals among issuers from...
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