Healthcare Insights
Gain a deeper understanding in payment integrity and a variety of healthcare topics.
Data Mining for Payment Integrity–knowing which rocks to turn over
MedReview works with clients to help them uncover savings opportunities. [...]
Provider Abrasion: A Natural Outcome of Payment Integrity
Provider abrasion results when the objectives of healthcare providers and [...]
Upcoding, a Common Medical Fraud Exposed
Upcoding is a fraudulent medical billing practice that takes various forms, but typically involves inflating the complexity or severity of a patient's condition.
MedReview Is Honored to Celebrate with the Child Care Corporation
Our partnership with 1199SEIU Funds spans more than a decade. Our dedication to the health and wellbeing of children and teens lasts a lifetime. Thank you for all you do to support children and their families in this community!
Sepsis Upcoding Is Costing Health Plans a Fortune
Sepsis is one of the most frequently diagnosed DRGs. It’s also one of the most expensive. The condition has been a hotly contested issue among providers, payors, and regulatory agencies for decades, and remains a continued source of disagreement today.
Top 5 Ways Smaller Health Plans Can Realize Big Savings
In today’s increasingly complex healthcare landscape, small- to medium-sized health plans may lack the scope and depth of clinical resources to fully establish a proven payment integrity solution.
Americans Paying Billions for Drugs That Don’t Work
Created in 1992 in response to the AIDs crisis, the Food and Drug Administration (FDA) accelerated approval pathway is intended for drugs that address unmet medical needs.
AHIP 2022 Is History. But Its Lessons Are Driving the Future of Healthcare.
In its first live conference since 2019, AHIP’s flagship event brought together some of the brightest minds in the industry to share insights and innovations that have the power to reshape the future of healthcare.
Sepsis Coding Issues Support Enhanced Payment Integrity
OIG recommends continued vigilance and targeted clinical reviews to ensure proper documentation.