Payer Audits: Commercial Payers Pick Up Where Medicare Leaves Off

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SSI Group

Commercial health insurers usually recognize a good idea when the government has one, and they are once again following Medicare's lead by increasing the number of claims they audit. Many providers are seeing an uptick--sometimes a very sharp one--in requests for additional documentation on patient charges, even though Medicare's Recovery Audit Program has been in a lull lately while it revamps.

In June 2016, a three-question survey on audit management was sent to members of the HealthLeaders Media Council, which comprises executives from healthcare provider organizations. According to the survey, providers face multiple challenges in dealing with payer audits. Respondents were divided about which aspects of payer audits pose the biggest challenge.

To find out more, download this complementary report today!

Customize Care Anywhere wish Digital Signage: 10 Tips for Using Digital Signage to Improve the Patient Experience

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When patients are more at ease, they perceive their experience in a more positive light. Digital signage from Lenovo Health is one way to better engage, inform and educate both patients and their visitors. What are the best ways to leverage this versatile technology in a healthcare setting? Here are 10 tips for using digital monitors to improve the overall patient experience and enable providers to better coordinate care across the facility, starting at the administration level.

Bridging the Patient ID Accuracy Gap

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Correctly identifying patients and accurately matching them to their medical records as they are shared across healthcare settings continues to be a troublesome (and costly) administration problem. To learn more about how today’s technology can help improve patient identity accuracy, download this complimentary infographic!

Why Hospitals and Health Plans are Turning to Credentials Verification Organizations

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In the 2002 movie Catch Me If You Can—a true story—actor Leonardo DiCaprio charmingly plays Frank Abagnale, Jr., a teenager who poses as a Georgia physician, among other impersonations, and manages to work in a hospital, all without a medical degree. While comical on-screen, this is every CEO’s nightmare, and it’s just one of many reasons why hospitals must continuously invest in a comprehensive credentials verification process. Hospital medical staff services departments, which handle credentialing and privledging, are now challenged by increased scrutiny from government regulators and accreding bodies. Dr. Matthew Allswede, MD, director of OB/GYN residency training with Michigan State University and Jodie Chant, MPA, a certified provider credentialing specialist and credentialing consultant, discuss why physicians like working with centralized credentials verification organizations (CVOs) and what to look for when choosing a CVO partner.

The Advancing Role of Advanced Practice Clinicians: Compensation, Development, & Leadership Trends

Sponsored by
Integrated Healthcare Strategies

The demand for Advanced Practice Clinicians or Advanced Practice Providers such as Physician Assistants, Nurse Practitioners, and Certified Professional Midwives in hospitals and health systems has grown exponentially over the past decade. With the rapid transformation of healthcare and the increased emphasis on the entire healthcare continuum, APCs are filling gaps and providing quality, patient-centered medical care. The enormous importance of these practitioners to the healthcare industry cannot be overlooked.

Download this eBook for methods on how to:

  • Simplify and standardize communication — across all care settings
  • Leverage the investment in the EMR
  • Enhance efforts to increase physician satisfaction and engagement
  • Facilitate more efficient care coordination to ease and expedite patient transitions
  • Improve clinical integration efforts; physician alignment
  • Reduce patient care delays and support initiatives to increase throughput
  • Enable a more comprehensive HIPAA-compliance strategy to reduce compliance risk

Written by Susan O'Hare, Managing Director & Senior Advisor, and Aurora Young, Principal Consultant of Integrated Healthcare Strategies

Revolution in Healthcare Consumerism: Major Market Shifts Impacting Your Health System

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It is no surprise that healthcare has changed and recycling old marketing strategies won’t lead to success. Learn more about trends reshaping healthcare and new and effective marketing approaches in this rapidly changing market.