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Denials Going from Bad to Worse

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Manage episode 448494916 series 2288292
Content provided by RACmonitor. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by RACmonitor or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://staging.podcastplayer.com/legal.

Denials in healthcare are a problem.

Recently, though, the problem seems to be getting worse, especially with the misapplication of the Two-Midnight Rule by Medicare Advantage (MA) plans, according to Nick Hut, senior editor for Healthcare Financial Management Association (HFMA).

Hut reports that MA plans are classifying hospital stays as outpatient observation visits at a significantly higher rate than traditional Medicare even though the rule is supposed to be applied the same way in both programs.
And Hut believes the situation is likely to be getting worse because UnitedHealthcare is targeting provider coding while it seeks to bring down medical spending that has been higher than anticipated in recent fiscal quarters.

Hut will be reporting this story during the next live edition of Monitor Mondays. He has more than 12 years reporting healthcare policy news and trends.

Other segments during the weekly broadcast will include these instantly recognizable features:

• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.

• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.

• Legislative Update: Adam Brenman, senior legislative affairs analyst for Zelis, will report on current healthcare legislation.

• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.

  continue reading

Chapters

1. Denials Going from Bad to Worse (00:00:00)

2. Ronald Hirsch, MD (00:01:05)

3. Knicole Emanuel, Esq (00:06:02)

4. RACmontior Commercial (00:11:31)

5. David Glaser, Esq (00:12:31)

6. Adam Brenman (00:17:08)

7. RACmontior Commercial (00:21:32)

8. Q&A With David Glaser (00:22:32)

9. Closing (00:28:13)

355 episodes

Artwork
iconShare
 
Manage episode 448494916 series 2288292
Content provided by RACmonitor. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by RACmonitor or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://staging.podcastplayer.com/legal.

Denials in healthcare are a problem.

Recently, though, the problem seems to be getting worse, especially with the misapplication of the Two-Midnight Rule by Medicare Advantage (MA) plans, according to Nick Hut, senior editor for Healthcare Financial Management Association (HFMA).

Hut reports that MA plans are classifying hospital stays as outpatient observation visits at a significantly higher rate than traditional Medicare even though the rule is supposed to be applied the same way in both programs.
And Hut believes the situation is likely to be getting worse because UnitedHealthcare is targeting provider coding while it seeks to bring down medical spending that has been higher than anticipated in recent fiscal quarters.

Hut will be reporting this story during the next live edition of Monitor Mondays. He has more than 12 years reporting healthcare policy news and trends.

Other segments during the weekly broadcast will include these instantly recognizable features:

• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.

• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.

• Legislative Update: Adam Brenman, senior legislative affairs analyst for Zelis, will report on current healthcare legislation.

• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.

  continue reading

Chapters

1. Denials Going from Bad to Worse (00:00:00)

2. Ronald Hirsch, MD (00:01:05)

3. Knicole Emanuel, Esq (00:06:02)

4. RACmontior Commercial (00:11:31)

5. David Glaser, Esq (00:12:31)

6. Adam Brenman (00:17:08)

7. RACmontior Commercial (00:21:32)

8. Q&A With David Glaser (00:22:32)

9. Closing (00:28:13)

355 episodes

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