On-Demand: The PHE ends May 11. What do hospitals and providers need to do right now?

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CMS Gives Clear Indication the Public Health Emergency Will Soon End. What does this mean for you?

By Angela Sorbelli, J.D., LL.M, MBA, CHC On April 7, 2022, the Centers for Medicare & Medicaid Services (CMS) issued a Press Release detailing the beginning of the phase-out activity for the temporary emergency waivers that have been in effect since the beginning...

COVID-19 Provider Relief Fund Updates

Additional Funds, Delay in Reporting Requirements, and Audits The Provider Relief Fund (PRF) was established when Congress passed the Coronavirus Aid, Relief, and Economic Security (CARES) Act to support American families, workers, and healthcare providers in the...

What Your Denial Rate Is Not Telling You

Let’s talk about denials, a frequent and often unpleasant topic in Utilization Management (UM). One of the core beliefs of most UM teams is that denials are bad, and most of UM teams’ efforts are spent trying to prevent or reduce denials. You may have even purchased...

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