Clinical and administrative staff at many organizations are struggling with the issue of what "medically necessary" really means - even those who have reviewed the Medicare Benefit Policy Manual (MBPM ...
One of the best defenses is a strong offense. This can be achieved by including a physician's medical necessity documentation in all or most charts. Q: One of the biggest challenges for case ...
Even though the majority of diagnostic tests and treatments ordered by physicians are performed and billed by someone else, physicians' perception of medical necessity "being a hospital thing only" ...
Most hospital leaders understand the financial risk of prior authorization breakdowns. But another source of revenue leakage is gaining attention: claim denials tied to medical necessity. These ...
In a blog post, Anesthesia Business Consultants CEO and President Tony Mira examined the changing anesthesia documentation and billing landscape. Here’s what you should know. 1. The simple days of ...
Please provide your email address to receive an email when new articles are posted on . For several years, media reports alerted the U.S. public to inconsistencies in the delivery, consumption, costs ...
In an era of value-based care, providing documentation of medical necessity and using evidence-based standards of care are essential to reduce waste while ensuring providers are appropriately ...
Watching how we, as humans, react to threats is a fascinating experience. From the time we were in elementary school we have seen how different people react differently to the same situation. Do you ...
A focus on front-end revenue cycle efficiency can help to avoid costly medical necessity denials. Denials are at the top of mind for revenue cycle leaders, and it’s not uncommon for denials to come ...
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