Utilization Management Archives | Trend Health Partners
Accuracy changes everything.
IDENTIFY
RESOLVE
PREVENT
Overpayments
Identify, resolve, and prevent unnecessary spend.
✓ Data Mining & Recovery
✓ COB Identification & Recovery
✓ ESRD Audit
✓ Clinical & Coding Validation
✓ AI Labs / Payer Intelligence
Credit Balance
The intersection of payment accuracy.
✓ Credit Balance Audit + TRENDSubmit
✓ Credit Balance Management & Prevention
Underpayments
Identify, resolve, and prevent revenue leakage.
✓ Denial Management
✓ Zero-Balance Accounts Analysis
✓ AR Rundowns
Shifting the Focus from Denial Management to Denial Prevention
As the volume of denials continues to increase, hospitals and health systems need a more proactive approach to denial management and prevention. Providers are encouraged to move from a denial management framework to a denial prevention framework to capture appropriate...
Improving Hospital Denials by Department
A hospital’s denial issues vary based on the organization, and because of this, sometimes pinpointing potential denials can be difficult. Moving from a management to a prevention model is a slow process, and issues can potentially arise if denials by the department...
4 Ways to Prevent Disallowed Charges From Bundled Claims
For the past few years, Medicare has been testing out new ways to bundle claims. The goal of this bundled claim switch is to improve care and reduce costs. A few apparent benefits in the bundled claims model have already been tested. One is simplifying the billing...
Utilization Management to Increase Patient Satisfaction
What is a health system without patients, or patients without a health system? Patient satisfaction is overwhelmingly important to the growth and success of a health system, and in turn, they expect the utmost care. That doesn’t mean the system is without its...
Optimizing Your Revenue Cycle: Best Practices & Recommendations
What is Utilization Management? Utilization Management assures your patients receive the care they need and provides a base to start focusing on denial prevention. Utilization Management comprises three assessments: prior authorization, pre-bill reviews, and...
Optimizing Your Revenue Cycle: Strategic Partnerships
More than one-third of nurses plan to leave their positions by the end of 2022, prolonging the nursing shortage. In addition to nurses, there is a strong trend of struggling to retain revenue cycle staff. Approximately 25 percent of healthcare finance leaders report...