| Page 766 | Kisaco Research
  • Implementing various strategies to encourage appropriate utilization of emergency outpatient facilities, such as: network management, preauthorization and utilization reviews, promoting alternative care settings, and investing in care coordination programs to prevent unnecessary readmissions.
  • A look to how data analytics can be leveraged to identify patterns of overbilling or potential fraud within emergency outpatient facilities
Track 1: Payment Integrity
  • Unveiling the audit landscape and understanding the importance of timely responses
  • Expediting audit responses through the establishment of a dedicated audit response team, implementing standardized documentation and track systems, and utilizing advanced technologies
  • Discussing the value of analyzing audit findings and leveraging them as opportunities for continuous improvement in revenue cycle management
Track 2: Revenue Cycle Management & Revenue Integrity
  • Investing in strategies that promote effective care transitions, care coordination, patient education, and data analysis
  • Working with providers to identify patients at higher risk of readmission
  • Reducing avoidable readmissions to achieve better overall quality of care and support cost savings
Track 1: Payment Integrity
  • Providing an overview of the No Surprises Act, an explanation of key provisions, and the impact it has had on provider billing practices
  • Highlighting how the No Surprises Act has influenced provider-payer interactions and insights into new payment methodologies introduced by the act to resolve billing disputes
  • Examples of how providers have adapted their practices to comply with the act
Track 2: Revenue Cycle Management & Revenue Integrity
  • Highlighting key pain points that health systems face in PI operations and how it impacts their operations
  • Talking about “what if” scenarios or successful use cases of AI and data management to help in AI operations
  • Painting a picture of outlook of PI with emphasis on pre-pay
  • Picture vendor landscape and talk about Everest Group findings in the market
Track 1: Payment Integrity
  • Elucidating the impact of value-based care on revenue cycle management, including the need for new metric, payment models, and performance measures
  • Revisiting existing RCM approaches and understanding how RCM can be optimized based on value
  • Case studies of successful revenue cycle management transformations based on VBC principles
Track 2: Revenue Cycle Management & Revenue Integrity