Think Like a Reviewer: Utilization Review
One of the many ways in which healthcare organizations are assessed these…
5 Issues Associated with Medical Necessity
Medical Necessity | EditsThere are few things more frustrating to a physician…
Developing Clinical Pathways
When it comes to patient safety, the best way to be prepared…
How Telehealth Will Support the Triple Aim
Triple Aim 101 You’ll recall that the Centers for Medicare and Medicaid has…
5 Values You Should Prize in Physician Compensation Models
When it comes to shifting models of physician compensation, there are…
5 Steps to Achieving URAC Specialty Pharmacy Accreditation
For many patients with complex, chronic illnesses, specialty pharmacies are the crux…
15 Reasons Your Claims May Have Been Denied
A claim could have been denied for many reasons. The question is,…
7 Ways to Reduce ER Admissions and Readmissions
For many hospitals, the emergency room is the busiest place for both…
Are ACOs Just HMOs in Disguise?
When we talk about Accountable Care Organizations (ACOs) , a lot of…
Understanding the Revenue Cycle
Understanding the revenue cycle can be tricky for many of us who…