For the second year in a row, Ensemble earned the Energage Top Workplaces USA Award. Ensemble was also Certified™ by Great Place to Work®. … Read More
Monthly Archives: January 2023
CMS Proposes Updates to Medicare Advantage Utilization Management Policies + Overpayment Standards: Comments Due Feb. 13
CMS issued a proposed rule that could change utilization management and prior authorization criteria for Medicare Advantage plans. … Read More
Be Prepared for Increased Medicare Bad Debt Compliance Scrutiny
OIG and CMS agree more scrutiny is needed for Medicare bad debt reimbursement and encourage more regular review of bad debts claimed. … Read More
3 Ways to Dramatically Reduce Denials
With financial pressures increasing, providers can’t afford not to implement effective denial management and prevention strategies. … Read More
OIG Advisory Opinion: Providing Nurse Practitioner Services for Referring Physicians Poses Minimal Anti-Kickback Risk
The OIG issued an Advisory Opinion on nurse practitioners providing services that are traditionally performed by primary care physicians. … Read More
Beyond the Payment Variance Report
Experts share common issues that lead to costly underpayments as well as effective resolution strategies leveraged across 200+ hospitals nationwide. … Read More
A Case Study on the Value of a Second Opinion
Having the courage to invite others into your environment increases your opportunity to improve yourself, your organizations and your KPIs. … Read More