Protecting revenue integrity in the age of denials — 4 takeaways

Becker's Healthcare November 13, 2024
In collaboration with CorroHealth

During a featured session at Becker’s 9th Annual Health IT + Digital Health + RCM Conference, CorroHealth’s Senior VP Samuel Dominik, and Senior VP of Clinical Documentation and DRG Integrity Bilal Mushtaq, MD, discussed the complexity of Diagnosis-Related Groups (DRGs) revenue integrity and the financial pressures faced by hospitals.

Macro trends affecting hospitals, such as Medicare Advantage and shifting coding requirements have led to increased DRG downgrades and denials. The speakers emphasized the importance of data analytics, accurate clinical documentation and second-level reviews to prevent denials.

Four takeaways:

1. Staff shortages and clinician turnover often result in inconsistent documentation and revenue leakage.

   “Retention is a big problem on CDI teams. Health systems make some investment in training these folks and...

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