Payers have a relentless pursuit of profit margin; meanwhile, most hospitals continue to operate in the red. Medicare Advantage and so-called “frictionless healthcare” are adding to the confusing ways payers behave, muddying the waters and masking denials. So, what can providers do about it? This workshop will present strategies that will help you get your house in order, hold accountabilities, enforce your rights, and escalate payer issues – all with the goal of changing payer behavior. Learn more about payer behaviors today evolving payer behaviors that are on the horizon.
CDI
The UM & CDI Continuum from the ED to the QIO – Part 2
Utilization Management and CDI are often discussed in silos, but they shouldn’t be. Impactful transformation happens when data is leveraged from both of these vectors in the clinical revenue cycle to establish a real baseline. Join us for another journey through the Clinical Revenue Cycle from the emergency department to the QIO and beyond.
On-Demand: The UM & CDI Continuum from the ED to the QIO – Part 2
Utilization Management and CDI are often discussed in silos, but they shouldn’t be. Impactful transformation happens when data is leveraged from both of these vectors in the clinical revenue cycle to establish a real baseline. Join us for another journey through the Clinical Revenue Cycle from the emergency department to the QIO and beyond.
On-Demand: The UM & CDI Continuum from the ED to the QIO- Part 1
Utilization Management...
On-Demand: HCC’s What’s the 411 for the Inpatient: CDS & Coder
Join us for an overview of CMS HCC risk adjustment fundamentals for the inpatient clinical documentation specialist and coder. We will review the top ten commonly under-reported diagnoses that map to a CMS HCC, review how risk scores are calculated, impact payment, and benefit from improved clinical documentation and comprehensive coding.
The UM & CDI Continuum from the ED to the QIO – Part 1
Utilization Management...
HCC’s: What’s the 411 for the Inpatient CDS & Coder
Join us for an overview of CMS HCC risk adjustment fundamentals for the inpatient clinical documentation specialist and coder. We will review the top ten commonly under-reported diagnoses that map to a CMS HCC, review how risk scores are calculated, impact payment, and benefit from improved clinical documentation and comprehensive coding.
On-Demand: Savvy Sequencing Using the “Two or More” Guideline
You’re confident your team is doing it all it can to ensure appropriate reimbursement. You perform CDI reviews, diligently review mismatches, perform coding quality assurance reviews, and utilize prebill DRG optimization applications, but are you certain that your team uncovered all the revenue optimization opportunities? Join this session to learn more, ask questions, and engage with Angela Carmichael.
Savvy Sequencing Using the “Two or More” Guideline
You’re confident your team is doing it all it can to ensure appropriate reimbursement. You perform CDI reviews, diligently review mismatches, perform coding quality assurance reviews, and utilize prebill DRG optimization applications, but are you certain that your team uncovered all the revenue optimization opportunities? Join this session to learn more, ask questions, and engage with Angela Carmichael.
On-Demand: CMI Benchmarking + CMI Acuity Adjusted Variance, Now What? How to attack the gap
Case Mix Index (CMI) is...
Clinical Documentation & Coding
: Versalus Health’s Documentation and Coding Integrity Program uses a data-driven approach to empower DRG case reviews.