Medicaid funding is tightening and uncompensated care is climbing. As those pressures mount, health systems can’t afford for the clinical and financial value of care they provide to go unrecognized.
Much of that gap is structural. Targeted and retrospective reviews reach only a fraction of encounters and can miss the clinical nuance buried in unstructured documentation, even as payers increasingly use automation to scrutinize claims.
In this session, health system leaders will share how they can move beyond cost-cutting to more accurately capture the value of care already provided. They’ll walk through a model that combines physician-governed AI with physician and coding expertise to identify and resolve documentation opportunities within existing workflows, rather than creating another work queue for already stretched teams.
In this 60-minute discussion, you’ll learn:
- How reviewing every inpatient chart before billing can strengthen reimbursement and quality metrics reporting
- Where targeted and retrospective review methods can leave earned revenue unrecognized
- How to improve documentation and data accuracy without adding to CDI and coding workloads