PYA Principal Martie Ross was recently quoted in a Report on Medicare Compliance article, “Hospitals Find Ways to Reduce Seven-Day Readmissions, but 30-Day Denials Provoke Ire.” The article highlights what some hospitals are doing to reduce readmissions and what can be done to address payer denials.
Article excerpt:
In its readmission reviews, United will consider whether the hospital adequately addressed the social determinants of health, [Martie] Ross says. If readmissions are declared clinically related, reviewers move onto whether they were “potentially preventable,” and one of the factors is “whether documentation supports that all salient financial and social needs of the patient have been addressed.” That presents new challenges for hospitals, Ross says.
If you would like more information about readmissions and payer denials, or would like assistance with any matter involving strategy and integration, valuation, or compliance, contact a PYA executive below, (800) 270-9629.
