A denial management strategy is always a work in progress

Auditing and quality checks on your denial management tool and processes will ensure they remain effective I recently helped a hospital review and redesign its denial management strategy. Some time ago, when 835s were introduced to streamline explanation of benefits (EOB) processing, the client partnered with a reputable vendor to identify and purchase a tool […]

A Guide To Medicare’s Readmissions Penalties And Data and other healthcare news articles – December 10 – 17

Our selection of top healthcare news articles from around the web "New ACO Rules Would Delay Penalties An Extra Three Years | Kaiser Health News" http://t.co/n6w95Q8MM7 by @KHNews #medicare #hospitals — BESLER Consulting (@BeslerDotCom) December 11, 2014 Readmission risk higher for poorest seniors – FierceHealthcare http://t.co/3gd4De66gv — BESLER Consulting (@BeslerDotCom) December 12, 2014 "AMA Joins […]

Key elements of 2-Midnight rule documentation

  The key elements of the 2-Midnight rule require documentation in the medical record for medical necessity and a presumption of the length of stay. The focus of the documentation requirements for Medicare inpatient admission is as follows: • Inpatient admission order at the time of admission by a physician or qualified practitioner licensed by […]

A Guide To Medicare’s 7 must-know provisions of the proposed MSSP ACO rules and other healthcare news articles – December 3 – 10

  Our selection of top healthcare news articles from around the web Brady Unveils Discussion Draft to Improve Hospital Issues in the #Medicare System http://t.co/cM9lQDgjbR by @waysandmeansGOP — BESLER Consulting (@BeslerDotCom) December 3, 2014 "7 must-know provisions of the proposed MSSP ACO rules" http://t.co/M3BCJFYtPB by @beckershr #medicare — BESLER Consulting (@BeslerDotCom) December 4, 2014 "CMS […]

How does the day of discharge affect hospital readmissions?

The day that patients are discharged from a hospital may seem like a routine statistic, but it could offer a window into potential process changes that may affect readmission levels. There are many reasons why patients are readmitted to a hospital. Hospitals are now identifying patients who have been readmitted or are likely to be […]