BHM Blog
Sharing what we learn begins here
Denial Management: Optimizing Revenue and Patient Care
2023-12-01T15:35:07-04:00By Brandon Ruse|Clinical Operations Improvement, Healthcare Independent Review|
The significance of effective denial management cannot be overstated, as the healthcare industry grapples with evolving regulations, complex billing systems, and increasing patient volumes.
Enhancing Patient Outcomes: The Profound Impact of Healthcare Consulting Services
2023-11-28T18:29:55-04:00By Brandon Ruse|Lean Management, Services|
Amidst this quest for excellence, healthcare consulting services have emerged as a catalyst for positive change. These services play a pivotal role in shaping the trajectory of healthcare organizations, guiding them towards efficiency, improved quality of care, and ultimately, better patient outcomes.
Real-World Cases on Standardized Peer Reviews
2023-11-21T17:13:27-04:00By Brandon Ruse|Clinical Analysis, Clinical Operations Improvement, Utilization Management|
In the intricate landscape of healthcare, the peer review process stands as a cornerstone for ensuring the quality and integrity of clinical practices. […]
Physician Peer to Peer Review Revolution
2023-11-20T16:30:31-04:00By Brandon Ruse|Clinical Analysis, Clinical Operations Improvement, IRO, Utilization Management|
Physician peer to peer review ensures reliability of medical decisions while fostering continuous development of internal clinical staff.
Decoding a Corporate Integrity Agreement
2023-11-07T11:57:07-04:00By Brandon Ruse|Healthcare Fraud and Abuse, Operational Analysis|
Corporate Integrity Agreement (CIA) is a legally binding contract, established between a healthcare provider and the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG), and plays a significant role in upholding ethical standards in the corporate landscape. In this comprehensive guide, we’ll delve into the intricacies of Corporate Integrity Agreements, understanding their significance, and how they contribute to ensuring ethical excellence in corporate practices.
Mastering the Clinical Review Process for Improved Quality
2023-11-09T16:57:32-04:00By Brandon Ruse|Clinical Analysis, Operational Analysis|
Clinical review, a vital component of the healthcare landscape, serves as a key mechanism for assessing and enhancing the quality of care provided to patients. In this comprehensive guide, we will explore the intricacies of mastering the clinical review process to ensure top-notch quality and patient satisfaction.
Accreditation Consulting in Healthcare: A Roadmap to Success
2023-11-07T10:50:42-04:00By Brandon Ruse|Accreditation, NCQA Accreditation, URAC Accreditation|
The need for high-quality care and patient safety is paramount. Healthcare organizations must continually strive for excellence and compliance with industry standards to ensure the best outcomes for their patients. One valuable tool in achieving this is accreditation consulting. Accreditation consulting can serve as a guiding light for healthcare organizations looking to attain or maintain accreditation, such as URAC or NCQA accreditation.
Bridging Gaps in Clinical Documentation Improvement and Quality
2023-10-27T11:51:23-04:00By Brandon Ruse|Clinical Analysis, Clinical Operations Improvement, Uncategorized|
In the ever-evolving world of healthcare, precision and accuracy are paramount. Clinical documentation stands at the heart of this, serving as the critical bridge between healthcare providers and patient care. In this blog post, we will explore the imperative for clinical documentation improvement, a crucial area that has the potential to reshape the healthcare landscape.
In-Depth Behavioral Health Reviews Elevate Quality Metrics
2023-10-24T14:58:24-04:00By Brandon Ruse|Behavioral Health Integration, Clinical Analysis, Physician Advisor/Peer Review|
Behavioral health reviews have emerged as a cornerstone in the quest for improved mental well-being. In an era where mental health concerns are more prevalent than ever, the need for comprehensive evaluations has never been greater.
5 Effective Denial Management Strategies
2023-10-20T11:05:47-04:00By Brandon Ruse|IRO, Physician Advisor/Peer Review|
One critical aspect often becomes a significant stumbling block – denial management. Denials can be a major source of financial strain for healthcare providers, leading to delayed reimbursements and increased administrative burden.