Mykel Banks
Director, Acute Services
Recent articles from this author
Why Utilization Management Is Critical to Value-Based Care and Revenue Performance in Human Services
Wednesday, March 11 | Thought Leadership,Value-based Care
Behavioral health and human services providers face high authorization volumes, variable payer criteria and increased audit risk. Without a structured utilization management function, organizations are at risk of being reactive to denials instead of preventing them.
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Understanding and Preventing Claim Denials: A Strategic Approach
Thursday, February 20 | Post-Acute Care,Thought Leadership
Claim denials are a persistent challenge for inpatient facilities, leading to financial strain, administrative burdens, and potential disruptions in patient care. Effective claim denial management starts with understanding why claims are denied, so facilities can minimize risk, maximize reimbursement, and implement proactive prevention strategies.
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Utilization Review: The Impact of Quality Reviews
Thursday, November 09 | Post-Acute Care,Thought Leadership,Value-based Care
Utilization management (UM) is a cornerstone in the fiscal success of healthcare organizations and an essential component of the complex revenue cycle. A pivotal tool, utilization review (UR) is a proactive approach in evaluating hospital admissions.
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