HFMA White Paper
Today’s traditional Utilization Management processes involve subjective application of inpatient admission screening criteria and lack of standardization across payers and providers, leading to a steady increase of medical necessity denials.
Changing that reality requires partnership between providers and payers. The implementation of AI in Utilization Management can provide real-time insights into a patients' clinical picture and generate highly precise predictive analytics that facilitate the determination of the most appropriate level of care and care setting.
Read more in this HFMA published White Paper to learn how providers are able to reduce revenue leakage and rework from underpayments and denials, increase revenue cycle related efficiencies, and ensure appropriate reimbursement using AI. You’ll also learn how Hackensack Meridian Health leverages our proprietary Care Level Score (CLS) to ensure appropriate status upfront, helping to prevent avoidable denials.
Download the HFMA White Paper