Significant Risks Beyond Recruitment: Medical Directors and CMOs

Recruiting and retaining qualified Medical Directors and Chief Medical Officers challenge healthcare organizations of all types. Whether you  employ or contract these medical professionals, consider two recent cases as reminders of potential issues far different than recruitment and retention and considerably more financially damaging. Significant risks beyond recruitment exist and staying informed about new Stark Law rulings pays.

Not Waiting For Capitol Hill: Health System Leaders Move Ahead

Despite industry uncertainty about the fate of healthcare under the new administration and Republican Congress, health system leaders move ahead and are preparing for the future. A recent Premier Inc. survey show the target areas for improvements within their systems. The results signal growth concerns and why the leaders will not wait for Capitol Hill results.

Successful Delegation To Downstream Entities

Healthcare organizations face challenges regarding reduction of their medical and administrative costs because regulatory and administrative demands are increasing. Payers and providers must evaluate new partner relationships and solutions for work processes and potentially outsource administrative functions in order to offer competitively priced services to patients. Successful delegation requires planning.

IRO Transparency Project: Summary

Last year, we published a blog about Washington State's IRO Transparency Project. As the ACA evolves into the next phase of healthcare, states continue using tools and resources developed over the past five years. BHM's continues in its role as a leader in IRO services with an update on Washington's project.

Accreditation Success: Policy Preparation

Many organizations struggle with developing policies and procedures. Formatting policies and procedures for accreditation and re-accreditation present special challenges. Policies and procedures form the foundation for a smooth accreditation process and are only the beginning of a longer accreditation journey. BHM’s accreditation consultants are experts in developing award winning policies and procedures. With extensive experience working with many organizations earning URAC, TJC, NCQA and other accreditations, BHM’s library of formatted and up-to-date policies and procedures is extensive.

2017-04-02T13:28:05+00:00 By |Accreditation, Compliance|

5 Things to Look For in an Independent Review Organization Partner

Choosing an Independent Review Organization (IRO) for a meaningful partnership that drives improvement and cost savings can be a tough task. The importance of an IRO to help support effective decision making and give objective, unbiased reviews, can be crucial to your business. To ensure you choose an IRO that distinguishes itself through quality work, ongoing training, full compliance, and the latest technology, you’ll want to do your research. It’s very important to trust the organization you choose and you always want to make sure they are industry certified. The following is a 5 part checklist for selecting the right IRO Partner.

3 Ways Independent Review Organizations Help Save You Money

We’ve been talking a lot lately about Independent Review Organizations and the appeals process that accompanies them. The role of the IRO in the appeals process is to provide an unbiased 3rd party opinion on complicated reviews, helping to assure that all reviews are given the time and care they deserve. It’s a common illusions in the healthcare industry that taking care of things in house is the best and easiest way to save money—however this isn’t true when it comes to claim reviews. If you are trying to manage your denials in-house, it can actually be counterproductive if you’re trying to save money and even time. Let’s take a look at how outsourcing your IROs can save you time and money.

1 Day Left to Sign up For BHM’s Free WebClinic “Components of a Great Peer Review Program”

BHM's webclinic “Components of a Great Peer Review Program” goes live Wednesday, November 18th from 12:00pm to 1:00pm EST. You don't want to miss this great opportunity to receive expert advice related to Peer Review Services. Don't worry you still have time to sign up!

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