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AppriseMD Blog
Exploring effective denial management strategies makes a significant difference for a hospital’s bottom line. One key component that hospitals and health systems should no longer be overlooking is specialized physician advisors who can transform revenue cycles and ensure higher quality care while safeguarding revenue streams. The latest and best solutions for improving revenue cycle and […]
White Papers
The financial impact of the IPO list magnified with the rise of CMS-4201-F, giving rise to inpatient reimbursement for all MAO patients who require services designated on the IPO list. Hospitals need to ensure that the proper setting is scheduled when any Medicare or MA patient undergoes a procedure designated on the IPO list, and they should also follow any proposed additions and removals to the list closely to ensure appropriate treatment and reimbursement.
Case Studies
After overturning a four-day inpatient denial for a 13-week pregnant patient with hyperemesis gravidarum and severe pain, the insurance company medical director commented that it is very difficult to overturn these cases. Just another example of the importance of detailed follow-up Peer-to-Peer discussions, even in denied cases that seem “hopeless” to be overturned. CLINICAL SUMMARY: […]