Monitor Mondays

Denials Going from Bad to Worse


Listen Later

Denials in healthcare are a problem.

Recently, though, the problem seems to be getting worse, especially with the misapplication of the Two-Midnight Rule by Medicare Advantage (MA) plans, according to Nick Hut, senior editor for Healthcare Financial Management Association (HFMA).

Hut reports that MA plans are classifying hospital stays as outpatient observation visits at a significantly higher rate than traditional Medicare even though the rule is supposed to be applied the same way in both programs.

And Hut believes the situation is likely to be getting worse because UnitedHealthcare is targeting provider coding while it seeks to bring down medical spending that has been higher than anticipated in recent fiscal quarters.

Hut will be reporting this story during the next live edition of Monitor Mondays. He has more than 12 years reporting healthcare policy news and trends.

Other segments during the weekly broadcast will include these instantly recognizable features:

• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.

• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.

• Legislative Update: Adam Brenman, senior legislative affairs analyst for Zelis, will report on current healthcare legislation.

• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.


...more
View all episodesView all episodes
Download on the App Store

Monitor MondaysBy RACmonitor

  • 4.5
  • 4.5
  • 4.5
  • 4.5
  • 4.5

4.5

23 ratings


More shows like Monitor Mondays

View all
Fresh Air by NPR

Fresh Air

38,549 Listeners

Hidden Brain by Hidden Brain, Shankar Vedantam

Hidden Brain

43,719 Listeners

Pivot by New York Magazine

Pivot

9,558 Listeners

White Coat Investor Podcast by Dr. Jim Dahle of the White Coat Investor

White Coat Investor Podcast

2,449 Listeners

The Daily by The New York Times

The Daily

112,664 Listeners

Up First from NPR by NPR

Up First from NPR

56,879 Listeners

Core IM | Internal Medicine Podcast by Core IM Team

Core IM | Internal Medicine Podcast

1,144 Listeners

Talk Ten Tuesdays by ICD10monitor

Talk Ten Tuesdays

41 Listeners

The ACDIS Podcast by ACDIS

The ACDIS Podcast

56 Listeners

Post Reports by The Washington Post

Post Reports

5,459 Listeners

On with Kara Swisher by Vox Media

On with Kara Swisher

3,519 Listeners

The Mel Robbins Podcast by Mel Robbins

The Mel Robbins Podcast

20,964 Listeners

HBR On Leadership by Harvard Business Review

HBR On Leadership

164 Listeners

The Compliance Guy by Sean M. Weiss

The Compliance Guy

36 Listeners

Off the Record with Brian Murphy by Brian Murphy

Off the Record with Brian Murphy

23 Listeners