Case Studies
CDI Audit Reveals Missed Query Opportunities Impacting Revenue & Quality
Our client is large U.S. health system with multiple hospitals across the Southeast. This case study highlights findings from a comprehensive CDI audit evaluating query
Preparing for AI Adoption: How a CDI Audit Assessed Physician Documentation
Our client is a large U.S. health system with 1,000+ beds across multiple hospitals. As they prepared to implement an AI-powered coding solution, they sought
Case Study: Outpatient Infusion Denial Overturned For $61K Reimbursement
Clinical denials are rising sharply, now costing U.S. health systems over $20 billion annually in unrecovered reimbursement. Payers are tightening policies around high-cost outpatient and infusion
Case Study: Concurrent Utilization Reviews Improve Accuracy Rates & Reduce Overall Denials
Health systems across the U.S. face ongoing challenges with patient status accuracy, which directly impacts reimbursement integrity and denial rates. In many cases, limited real-time
Case Study: Complex ICU Denial Overturned for $128K Reimbursement
In the complex environment of revenue cycle management, clinical denials for medically necessary services can significantly impact reimbursement – especially in high-acuity cases. This case
Case Study: Extended LOS Denial with Social Factors Overturned for $84K Reimbursement
Social factors can pose significant challenges for hospitals seeking reimbursement for extended inpatient stays. While necessary, non-medical social factors can be frequently undervalued by payers,
What Clients Are Saying About Us
We were really pleased with attention to detail that was provided to us in the review of clinical appeals management and charge capture It was clear to see that your team knew what they were doing!
One of Managed Resources’ key strengths is communication; they are always communicating with us. They are always willing to get on the phone and provide their expertise. Even if we are struggling to write an appeal ourselves, they will help us navigate that and maybe provide language that will bolster the appeal’s outcome depending on the circumstances. – Director
I can honestly and without hesitation declare these to be the absolute finest, most thorough, comprehensive and convincing clinical appeal letters I have ever seen in my 25+ year career as a hospital revenue cycle leader.
Thank You, Thank You!! I found myself in a huge bind. Inpatient and outpatients accounts in backlog. Reaching out to you saved me. Not only did they provide High Quality Experienced coders, they got my backlog under control/caught up in no time.
These are these are great findings… really, really happy with it. This is exactly what we were hoping to get, this type of information to take back. Super happy with these results, and that we had substantial findings that we can take back to our teams and show to our executives.
CodingAID has worked with our physicians to provide valuable and timely coding and documentation education
The Managed Resources clinical appeals team have been excellent to us! Not only in having such a positive impact in recovering appropriate reimbursement for denials, but for their personal and timely approach to sharing educational tools with us to help prevent future denials. They really provided us with a high quality of service.