Initial claim denials hit 11.8% in 2024. Learn how to shift from reactive appeals to proactive denial prevention by identifying cross-payer patterns before they cost you.
Discover when to shift from reactive appeals to proactive denial prevention by identifying cross-payer patterns costing your organization revenue.
Healthcare loses 3-5% of revenue from charge capture errors. Learn how to identify gaps and recover millions in unbilled services.
If you run a hospital or health system, you know the gut punch that comes with Diagnosis Related Group (DRG)…
Here’s something that should get your attention: the Centers for Medicare & Medicaid Services (CMS) announced they’re expanding Risk Adjustment…
Healthcare organizations lose between 2% and 5% of net patient revenue annually due to inefficient revenue cycle management practices, with…
RAC and RADV audits require different preparation strategies. Learn how to protect your organization from recoupments with audit-specific workflows.
Why prospective audits are replacing retrospective reviews. Learn how preventing errors before submission improves cash flow and reduces denials.
OIG scrutinizes Medicare sepsis billing in 2024; hospitals must improve documentation and audits to ensure compliance before FY 2025.
Healthcare organizations face an increasingly complex audit landscape where Recovery Audit Contractor (RAC) audits and Risk Adjustment Data Validation (RADV)…
The landscape for Risk Adjustment Data Validation (RADV) audits has shifted dramatically in 2025, and Medicare Advantage Organizations (MAOs) face…
Learn how OIG scrutiny of sepsis billing affects hospitals. Discover strategies for documentation compliance, audit readiness, and navigating Sepsis-2 vs Sepsis-3 definitions
