A 5-Step Guide – Employee Investigations in the Health Insurance Industry
Navigating Employee Investigations in the Health Insurance Industry: A Five-Step Guide In the health insurance sector, maintaining compliance with both company policies and the intricate
Understanding the Long-Term Costs of the Optum Health Change Healthcare Cyber Attack
In today’s digital age, cyber attacks have become a prevalent threat to organizations across various industries. The recent cyber attack on Optum Health’s partner, Change
A Cookbook to Revamping – Healthcare Revenue Cycles through Prior Authorizations
Just as a skilled chef carefully prepares a meal, healthcare revenue cycle leaders must skillfully manage the Prior Authorizations (PAs) process. It’s a balancing act
CMS’s Final Rule: A Step Towards a More Streamlined & Transparent Healthcare System
The Centers for Medicare & Medicaid Services (CMS) recently revealed that they have finalized a transformative rule, ushering in a new era for increased access
Navigating the Tensions: Providers, Insurers, and the Future of Healthcare
In recent times, the tension between health insurers and providers has amplified due to an array of elements such as rising labor costs, supply chain
Unraveling DNFB in Healthcare: A Guide to Understanding and Managing “Discharged Not Final Billed”
In the world of healthcare management, you may stumble upon numerous acronyms and jargon that might seem a little overwhelming. One of the critical terms
Intersecting Healthcare Roles: Practitioner Educator Innovator
Introduction As the healthcare field evolves, it is essential to stay on top of new developments and advancements. Healthcare Systems adjunct professors have a unique
Benchmarking Prior Authorization: A Deep Dive into Approval and Appeal Rates
With the growing complexities of healthcare, Prior Authorization (PA) has emerged as a crucial player in healthcare delivery. As a preventive measure implemented by insurance
Mastering Prior Authorization: A 5-Benchmark Approach
Developing benchmarks for your team is essential to ensure your tasks and projects are progressing as hoped. Here’s an example of how you could set
Understanding and Avoiding Medical Necessity Write-offs
Over the last few years, a major concern for health providers and institutions has been the increasing number of medical necessity write-offs. These are charges
Michael Brethorst, MS
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