by Aspirion | Feb 28, 2023 | Clinical Denials, Denials Management
As revenue cycle management experts, we’re always looking at the broad picture of denied accounts placed with Aspirion to see where there is an uptick in payer denials. One area of uptick relates to level of care denials. Although hospital Utilization...
by Aspirion | Feb 20, 2023 | Clinical Denials, Denials Management, Denials Prevention, Patient Experience
This Denials Management and Prevention Session 1 webinar establishes the groundwork for how medical professionals decide whether an individual should be treated medically — as an inpatient or outpatient. In addition, the Aspirion presenters will outline the denial...
by Aspirion | Nov 21, 2022 | Clinical Denials, Denials Management, Patient Experience
Prior authorization requirements have been around for decades, and frustration from providers is nothing new. But a new report suggests that abuse of these policies is compounding hospitals’ already cratering finances and pushing relations with health insurers to the...
by Aspirion | May 20, 2022 | Clinical Denials, Denials Management
It is relatively easy to identify the root cause of an inpatient denial due to a procedural matter like failure to obtain an authorization. But what is the root cause of an inpatient denial when the hospital does everything ‘right’? They notify the correct insurance...
by Aspirion | Aug 31, 2021 | Clinical Denials, Complex Claims, Denials Management
Many times, payers deny specific patient treatments, drugs, or hospital stays due to the specific treatment or drug being considered non-covered or experimental. While these claim denials can be argued in a formal appeal on the back end, a health system can also...
by Aspirion | Jul 7, 2021 | Clinical Denials, Complex Claims, Denials Management
Beginning July 1, 2021, United Healthcare (“UHC”) will begin reviewing Medicare Advantage and commercial claims for sepsis-related treatment on a pre-payment basis and post-payment basis. Previously, UHC only reviewed sepsis-related claims on a post-payment basis....