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Designing Provider Education Programs
An effective Provider Education Program (PEP) can improve clinical documentation, increase coding accuracy, and enhance overall revenue integrity. Health systems that implement well-structured education initiatives
Different Types of Charge Audits
A charge audit is a critical review process that evaluates the accuracy, completeness, and compliance of charges captured and billed by a healthcare organization. It
When is the Right Time for a Coding Audit?
Medical coding is at the heart of every revenue cycle operation. It ensures accurate reimbursement, compliance, and clinical data integrity. But even with experienced teams
What Are Unappealable Denials?
Denials are a natural occurrence in today’s healthcare reimbursement landscape. While some denials can be appealed and overturned through traditional processes, some complex cases are
What Are The Benefits Of Regular Charge Audits?
In an increasingly complex healthcare environment, ensuring that every service provided is accurately captured and billed is crucial. A clinical charge audit identifies missed charges
Clinical Documentation: The Risk of Non-Compliance
What is Clinical Documentation Improvement (CDI)? The Purpose of CDI Initially known as Clinical Documentation Improvement, now is known as Clinical Documentation Integrity. The purpose
KLAS Research: Managed Resources highlighted in 2024 KLAS Report
KLAS Research has published an Emerging Insights report reviewing Managed Resources’ Denials Management services. Managed Resources is proud to receive a 94.4% Overall Performance Score,
Social Factor Considerations in Addressing Medical Necessity Denials
As inpatient medical necessity denials continue to rise, it is important to evaluate possible drivers of change in the patient presentation and clinical encounter resulting
Top 4 Clinical Charge Audit Trends in 2024
1. Trends Seen in the Increase of Downgrades for Emergency Department Level Visits Many payers are developing proprietary algorithms for determining their own Emergency Department
FY2024 Codes for Caregiver Training Services
Medical coders must familiarize themselves with several new codes for Caregiver Training Services, which became effective January 1, 2024. These new services are intended to improve patient
Case Study: Clinical Appeals Collection
A collection of case studies involving clinical appeals challenges and revenue cycle solutions Managed Resources partners with healthcare systems, hospitals and payers across the United
Case Study: Unappealable Denials
How to Review & Determine the Most Difficult Cases Our client, a large four-hospital system, was facing a difficult challenge: THE CLIENT EXPERIENCED A SIGNIFICANT
What Clients Are Saying About Us
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.
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!
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.
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
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.
CodingAID has worked with our physicians to provide valuable and timely coding and documentation education
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.