Operator Insights: Utilization Management

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Operator Insights is a Revenue Cycle Management thought leadership series from Ensemble Health Partners, who was voted Best In KLAS for healthcare revenue cycle outsourcing in 2020. In this episode, Julie talks Utilization Management with Dr. Robert Wagner (EVP of Physician Services) about physician advisors, UR nurses, and the overall value of UM services.

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The Importance of HCC Coding

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Hierarchical Condition Category (HCC) coding is the risk adjustment (RA) model that is used by the Centers for Medicare and Medicaid (CMS) for determining future healthcare costs associated to a specific patient.

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Summary of October 1st, 2020 ICD-10 Code Updates

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Ensemble’s “Queen of Codes” Staci Booth provides a vital summary of the ICD-10 Code changes coming October 1st, 2020 and Q&A recap from her recent webinar regarding ICD-10 changes and COVID 19 specifications. 

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Documentation Tips: “Think in Ink”

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Accurate and complete documentation of medical necessity is key for both the patient and your organization. When done right, documentation leads to a higher quality patient experience, improved communication and sound clinical and financial outcomes.

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