New data from just under one million lab-based cases reveals systemic inefficiencies and rising denial rates, underscoring ...

PayerWatch, a leader in revenue integrity and insurance and audit denial management solutions for hospitals, today announced a strategic partnership with Hyve Health, a health data and intelligence ...

Gangadhar Vasanthapuram’s AI framework automates clinical audit narratives using LLMs and prompt engineering—enhancing ...

The gap between clinical care and financial performance has never been wider. As health systems expand services and patient volumes rise, revenue cycle teams are being held back by one of the most ...

The fourth report from the National Office of Clinical Audit covers 2023 and found high bed occupancy rates above 95%, staffing challenges and the increasing need for specialised paediatric ...

A recent CMS announcement signals a more aggressive approach to auditing Medicare Advantage plans. Revenue cycle leaders should be prepared for the ripple effects.

Was there no routine audit? Continuous review and audit of clinical practice, with a focus on improvement and applying the lessons learned, should be the cornerstone of any high-quality healthcare ...

Objective—To review the literature on the benefits and disadvantages of clinical and medical audit, and to assess the main facilitators and barriers to conducting the audit process. Design—A ...

Almost 500 children who underwent hip operations in two hospitals should be recalled, as close to 70 per cent of surgeries were not necessary, an independent audit has found. Furthermore, one ...