Payer strategies are evolving quickly, and healthcare organizations must be alert to make the most of revenue opportunities while mitigating claims denials. In light of recent denials and DRG downgrading by payers, how your organization adapts will profoundly affect your reimbursements. An organization’s own internal review can set the stage for monitoring and remediating any inappropriate downgrading of DRGs by the payer.
There are no upcoming events at this time.
About Panacea Insights
This author has yet to write their bio.Meanwhile lets just say that we are proud Panacea Insights contributed a whooping 95 entries.
Entries by Panacea Insights
Expansion — through mergers, acquisitions, joint ventures and other strategic partnerships — has become an important tool in a hospital’s strategic wheelhouse. As your footprint expands to encompass the entire continuum of care, how do you ensure your chargemaster strategy is sound and consistent?
We break this question into two parts — soundness and consistency — for good reasons:
First, in an era of increased public price scrutiny, hospital CFOs must ensure that their chargemasters are defensible and can be clearly explained to outside observers and auditors.
Second, mergers, acquisitions and other affiliations often bring under a single umbrella organizations that may have very different pricing and coding methodologies, practices and strategies.
In today’s complex health care environment, in which CMS and insurers each maintain their own claims-related “rules,” disputes, DRG downgrades and denials are all-too common.
Charge data and coding accuracy is more important than ever—but the challenges facing healthcare organizations have also grown exponentially. Help your organization stay ahead of the chargemaster curve with our complimentary one-hour webcast.
Are you are seeing rising claim rejections in your practice? Maybe you’re experiencing a slowing of reimbursement and consequential reduction in revenue since ICD-10. Learn how coding accuracy can reduce these denials and improve your results.