A recent study from the healthcare solutions company Premier indicated that $19.7 billion is what hospitals and health systems are spending annually on handling and appealing denials. Yes, that is “billions,” with a “B.” There are several reasons claim denials can occur, including but not limited to medical necessity, claim edits, pre-authorization, and others. Two […]

I attended the 2024 National Physician Advisor Conference (NPAC) hosted by the American College of Physician Advisors (ACPA) in the middle of April. Its theme was “Safeguarding Patients Amidst Shifting Currents of Healthcare.” I love this conference because it is so rich with information and expands my knowledge base beyond clinical documentation integrity (CDI). I […]