This session will identify the at risk issues related to 3 key areas with the payers: DRG downgrades, Inpt vs obs disputes and readmission denials. The additional challenges with Medicare Part C/Advantage will be addressed as the internal staff are confused! Learn contract language ideas too - all focused on identifying keys to documentation and new payer pathways.
Be able to identify at risk patterns per payer.
Be able to identify key contract language or lack of a contract at risk.
Be able to address the 3 key areas with appropriate internal action plans.