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Navigating Medicare Advantage: Strategies for Hospitals to Tackle Growing Challenges

EvidenceCare

Documentation Challenges and Payer Friction As MA plans focus on profit margins, hospitals are encountering increased payer friction, denials, and administrative burdens, particularly around the CMS Two-Midnight Rule. So, when you put in that inpatient order, it implicitly means you believe the patient will need that level of care.

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Basics of Medical Documentation: What Aspiring Medical Billers and Coders Need to Know

Northwest Career College

Accurate documentation is essential for medical billing and coding, but many beginners struggle to understand the technical terms and guidelines. Without accurate medical documentation, insurance claims can be delayed or denied, frustrating patients and physicians. What is Medical Documentation?

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5 Risk Control Considerations as Nurse Practitioners’ Scope of Practice Expands

Minority Nurse

Professional Liability Trends and Implications Professional liability trends are evolving as NPs take on greater responsibility for patient care. Where NPs have reduced or restricted practice authority to provide patient care, liability is often shared with supervising physicians (Candello, 2023). Documentation.

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Prior Authorization Is Changing

EvidenceCare

Today, it is a leading driver of care delays, administrative waste, and provider burnout—with surveys indicating over 90% of physicians reporting delays in patient care due to PA requirements. There is an incentive to ensure documentation supports services). Providers with strong compliance may earn exemption (i.e.,

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How to Embrace AI as Your Clinical Assistant

Valant

Many therapists use AI transcription services during sessions instead of documenting sessions by hand. Clinical documentation is a particularly important application of AI technology because documentation so often contributes to provider burnout. Improved work-life balance. More comprehensive notes.

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11 tips for onboarding new practice staff

Physicians Practice

Reynolds July 8th 2025 Article Discover effective strategies to reduce overhead costs in medical practices without layoffs, enhancing staff morale and improving patient care. 7 ways to cut overhead without cutting staff Keith A. 7 ways to cut overhead without cutting staff Keith A.

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Combat ED Denials and Burnout Through Smarter Documentation and Coding

Health Prime

Current industry data shows ED denial rates average 15–20%, with coding and documentation errors accounting for a significant portion of the denials. This problem is not only hurting emergency medicine physician groups and hospitals – it’s also hurting patients. missing MDM details for 99285) Unbilled procedures (e.g.,