Why It’s Time to Bring HCC Coding In-House
Recent advances in generative AI have made it a lot easier and safer to bring HCC coding in-house, lowering costs, and strengthening audit readiness.
The Case for a Universal Medical Coder in Achieving True Interoperability
A universal medical coder, applied consistently across care settings, offers a practical solution to the enduring challenge of data integrity.
The Power of One: Redefining Healthcare with an AI-Driven Unified Platform
In a landscape where complexity has long been the norm, the power of one lies not just in unification, but in intelligence and automation.
Privacy Rules Are Tightening, Again. Here’s How Your Healthcare Marketing Can Embrace Compliance to Thrive
How can healthcare providers contend with a regulatory environment that has never been more fragmented? Here are three lessons on why privacy is your competitive advantage.
Why Health Plans Are Reclaiming Utilization Management, and What It Takes to Do It Right
CMS and AHIP are raising the floor, but forward-thinking plans are aiming higher. They’re designing utilization management systems that are clinically sound, operationally efficient, and aligned with enterprise goals.
CMS and AHIP Isn’t the Finish Line: It’s the Starting Gun for Prior Auth Innovation
Without systemic redesign, these efforts risk reinforcing the same pain points that made prior authorization a flashpoint for payers and providers.
Advancing Patient & Planet Health Through Proper Healthcare Waste Management
By prioritizing sustainability-minded and compliant waste management in the workplace, healthcare leaders can advance patient and employee well-being, as well as environmental and fiscally responsible programs.
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RCM Outsourcing: Balancing Human Expertise & Smart Technology
Greenway Health blends smart technology with human expertise to elevate revenue cycle.
Best Practices in Managing Medical Equipment Rollouts
Successful implementation makes all the difference between a seamless changeover and a poorly executed one that interferes with the delivery of patient care.
Putting Part 2’s Data Privacy Protections into Play: 3 Key Considerations
If the guidelines for data sharing are not adhered to by providers, then all the work that has gone into revising this regulation will have been for nothing. But the road to compliance doesn’t have to be overwhelming. Here are three essential steps for healthcare leaders in navigating the soon-to-be Part 2 landscape.
4 Practice Policies that Help Maintain Behavioral Health Practice Success
Running a behavioral health practice requires balancing patient volume and case diversity, while maintaining operations. Transparent practice policies are necessary for success and ensuring high-quality, consistent patient care.
Common MRF Mistakes Hospitals Are Making in 2024
Updated schema requirements are easy to mix up — here are a few simple solutions
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Could QuantalX’s Device Make Managing Brain Health Easier?
CEO and neuroscientist Dr. Iftach Dolev on how the new device can bring a powerful tool to psychiatrists and neurologists alike.
Medicare Advantage Audit Ready with AI
Adding generative AI and other AI tools to coding and chart review practices streamlines a complex process and better positions plans for risk adjustment audits.
From FOMO to FOMU: A Framework for Getting AI Right
Healthcare is a highly regulated industry, and any use of AI within it is dealing with the most sensitive data. In order to ensure you’re not putting you, your company or patients at risk, consider an evaluation framework for any AI tool that considers these three things.
Corporate Compliance in the Era of TEFCA
A culture of compliance means truly valuing an adherence to industry standards, rather than looking at SOPs as a series of boxes that need to be checked in order to claim that requirements have been met.
From Risk to Trust: Tackling Inefficient Provider Verifications in 2024 and Beyond
The NCQA proposed standards updates are just one part of a healthcare landscape undergoing rapid transformation, but the imperative for optimizing operational processes has never been clearer.
Tax Challenges for Healthcare Accounting Teams Bring Opportunity for Innovation
A good outsourced partner can work alongside in-house accountants and stay on top of the moving target of healthcare accounting regulations, addressing tax risks and identifying cost-saving opportunities.