Ms. Butters shared the following tip with Becker’s Hospital Review.
“The clarity and perspective that technology provides to physician advisors when reviewing cases and providing medical necessity recommendations not only drives greater efficiency, but also establishes consistency from one review to another. By applying the same considerations to cases with similar clinical backgrounds and presentations, embedded guidance from a technology platform introduces a standardization of documentation and methodology which facilitates widespread acceptance of the clinical review process. As a result, clinicians can more easily generate an accurate and compelling case narrative for payers, as well as demonstrate a higher degree of inter-rater reliability — both of which lead to fewer denials down the line.”
Read more about reducing denials here.
If you would like to share your RCM best practices, please email Kelly Gooch at kgooch@beckershealthcare.com to be featured in the “RCM tip of the day” series.
