Understanding Medicare Advantage Plans & AI’s Role in Compliance
Understanding Medicare Advantage Plan & AI’s Role in Compliance TL;DR, Medicare Advantage Plan or MA market is fast-changing and highly competitive. According to the Chartis Report of 2023, Special Needs Plans (SNPs) have driven much of the market’s growth this year which reflects changes in beneficiary needs and insurer strategies. However, with time SNPs are […]
Read MoreHow to Write an Effective Insurance Appeal Letter?
Denial claims are one of the biggest challenges in the healthcare industry. RCM professionals consider them the worst nightmares. They can disrupt revenue management, impact cash flow, and create unnecessary frustration which diverts their focus from patient care. However, for the tld;r, a claim denial occurs when an insurance company refuses to reimburse a healthcare […]
Read MoreHow can Gen AI help win more Appealing Insurance Denial claims for healthcare providers?
U.S. healthcare staff have to write effective appeals daily. The major struggle is not writing them but winning them. As, appealing insurance denial creates administrative burden for healthcare providers teams. Staff needs to draft and submit appeals daily. Among the most frequent denials, medical necessity denials stand out which requires thorough documentation and precise justification […]
Read More4 Best Analytics Tools to Reduce Healthcare Denials by 30-50%
Healthcare denials are a significant issue for providers that directly affects their revenue stream. How? Each time providers resubmit a claim, they incur additional costs. To maximize revenue, modern healthcare organizations must focus on minimizing claim denials. Healthcare organizations should use denial management analytics to reduce claim denial rate. Effectively managing claim data requires expertise, […]
Read More