By Fran Jurcak, MSN, RN, CCDS, CCDS-0, Chief Clinical Strategist
Executive summary:
Even before the COVID-19 pandemic, hospitals struggled with mid-revenue cycle leakage. In 2019 (pre-COVID), Medicare and Medicaid underpayments had reached $75.8 billion¹ and 84% of healthcare leaders cited inaccurate clinical documentation and coding as the root cause of lost or decreased revenue.² The pandemic has only exacerbated the problem.
There isn’t a single root cause for mid-cycle leakage—it remains difficult for healthcare leaders to manage due to competing priorities, a lack of clinical knowledge, and a scarcity of appropriate software solutions. But healthcare leaders have options for mitigating mid-cycle leakage, and one of the most compelling strategies is to implement a thorough retrospective review process.
Download this whitepaper to learn:
- Why retrospective reviews are necessary
- Strategies for prioritizing what to review and how to implement a retrospective review process at your organization
- The impact of machine learning on retrospective reviews
¹ 2019 AHA Fact Sheet: Underpayment by Medicare and Medicaid January 2021
² HIMSS and Besler Revenue Cycle Management Research Report – Insights into Revenue Cycle Management October 2016
By Fran Jurcak, MSN, RN, CCDS, CCDS-0, Chief Clinical Strategist
Executive summary:
Even before the COVID-19 pandemic, hospitals struggled with mid-revenue cycle leakage. In 2019 (pre-COVID), Medicare and Medicaid underpayments had reached $75.8 billion¹ and 84% of healthcare leaders cited inaccurate clinical documentation and coding as the root cause of lost or decreased revenue.² The pandemic has only exacerbated the problem.
There isn’t a single root cause for mid-cycle leakage—it remains difficult for healthcare leaders to manage due to competing priorities, a lack of clinical knowledge, and a scarcity of appropriate software solutions. But healthcare leaders have options for mitigating mid-cycle leakage, and one of the most compelling strategies is to implement a thorough retrospective review process.
Download this whitepaper to learn:
Why retrospective reviews are necessary
Strategies for prioritizing what to review and how to implement a retrospective review process at your organization
The impact of machine learning on retrospective reviews
¹ 2019 AHA Fact Sheet: Underpayment by Medicare and Medicaid January 2021
² HIMSS and Besler Revenue Cycle Management Research Report - Insights into Revenue Cycle Management October 2016
