Articles

DRG downgrades, also known as clinical validation denials (CVDs), have been affecting hospital revenues for a number of years. Recently, though, hospitals have been experiencing a significant uptick in the volume of the CVDs. The article outlines an approach to addressing the increase in CVDs.

NPI denials can be far more complicated to resolve than at first glance. Read more to find out why.

Data analytics are key to conducting a comprehensive and efficient coding audit.

Read real world success stories about how the CBIZ Virtual Screening and Enrollment Portal (VSEP) was utilized to qualify two patients for Medicaid that would likely never had completed the application process otherwise.

Over-Utilization denials are like going to a restaurant, ordering dinner and eating it. And then when the bill comes, American Express decides that a desert wasn’t needed so they won’t pay the bill.  In this blog post our President Sam Donio talks about addressing why hospitals need to fight these denials.

With the rise of ventilation services, CBIZ’s assessment can help ensure that these high-dollar cases are being coded correctly.

This article will highlight some of the Biden Administration’s initial healthcare policy priorities.

What providers need to know about the upcoming telehealth audits.

Two stories that show CBIZ going above and beyond for our Eligibility clients and their patients during the pandemic.

How CBIZ helped a behavioral health organization utilize their new EHR and apply the 2021 E&M standards.

How Medicaid expansion states benefited in providing access to care over non-expansion states during the COVID-19 Pandemic.

Many organizations leave the task of ensuring compliance/evaluating performance of their contracts to automated contract management systems. Ultimately, do you really know what your contracted payers are actually paying?

The new 2021 E/M Rules have been in effect for a month; have you measured your performance?

Most Favored Nation (MFN) pricing for Medicare Part B drugs went into effect on Jan. 1 and will have a significant impact on many organizations. This article will explain key aspects of the new pricing rule.

How CBIZ assists Canadian hospitals with billing American insurance companies through charge capture.

E/M reimbursement is changing in 2021 for physician office visits. This article features many of the key updates for work RVUs and the Medicare conversation factor.

Ways to improve denial management.

This article details the importance of DRG validation for hospitals and evaluates the different approaches that hospitals can use for improving compliance and optimizing revenue.

Complying with the federal pricing transparency requirements

This article features innovative enhancements that hospitals are making post-COVID-19 to their patient registration process for Medicaid enrollment.

Ongoing monitoring of managed care contracts is essential to ensuring appropriate reimbursement.

This article will address the 2021 E&M reimbursement changes with medical decision making and the recording of time spent with patients.

Exploring discussions related to the changes of the Public charge rule and detailing potential impacts on Medicaid and Charity care programs.