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3 payment integrity imperatives in post-pandemic healthcare

HGS Healthcare leaders identify three main factors behind heightened payment integrity (PI) pressures post-pandemic (i.e., volumes and resources, regulation changes, telehealth) and explain how PI solution experts can help payers reduce those pressures.
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Building a successful data culture in the post-pandemic healthcare reality

HGS Healthcare's Ramesh Murugesan describes challenges in data science deployments, how to build a healthcare data culture, and the importance of the democratization of data and analytics.
medical billing and coding

5 provider coding myths, debunked

Over the past 18 months, healthcare providers have grappled with historic cost and care challenges. The COVID-19 pandemic has increasingly forced providers to assess new areas of transformation to unlock operational value and cost efficiencies.
new healthcare law

Health plan guidance: 3 essentials for no-surprises Act compliance

In recent years, the healthcare industry has increasingly…
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The human side of healthcare analytics

A recent study by Tempkin Group showed when individuals have a positive emotional association with a specific brand, they are 8.4 times more likely to trust the company, 7.1 times more likely to purchase more and 6.6 times more likely to forgive a company’s mistake.

Three ways healthcare engagement models differ from other industries

Healthcare engagement models differ from other industries in three ways: compliance needs, customer types, and org structures. A BPO can assist in minimizing differences to truly put customers first.
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For better RCM, prioritize people and track with technology

Proper revenue cycle management (RCM) involves careful documentation of the entire patient journey. Once captured by a proficient employee, patient and member data can be handed over to AI-based systems to reveal insights.
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Preventing and appealing clinical denials with analytics, automation, and AI

U.S. hospitals lose $262 billion due to denied claims each year, representing 10% of the total claims paid. Unraveling the root cause of denials costs an average of $118 for each claim. Applying modern technology — such as analytics, automation, and artificial intelligence (AI) — can help to increase the number of clinical denials investigated, boost appeal effectiveness, and unearth root cause.
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COVID-19 and healthcare: 3 areas of market focus

COVID-19 has heightened the focus on optimized provider data management, utilization management, nurse triage, and telemedicine for payers and providers, both during and after the pandemic subsides.
COVID-19 update

A COVID-19 update from our company’s consulting physician

Throughout 2020 and as we plan for 2021, HGS has trusted the…

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