Pre-Service
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Scheduled patients not pre-registered
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Pre-Certification not performed/late
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Medical Necessity determined after service
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Insurance verification not completed
Registration
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Errors
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Point of service - inconsistencies
Financial Clearance
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Self pay vetting not conducted
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Financing options limited
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Eligibility - no follow through
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Back end emphasis vs. front end
Patient Experience
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Patient complaints
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Redundant interaction with patients/families
Charge Capture
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CDM not updated/maintained
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Lack of ownership
Clinical Documentation
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Limited physician engagement
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Incomplete/missing documentation
Medical Necessity
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Limited Utilization Review interaction
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LOS issues
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High number of clinical denials
Health Information Management
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Coding backlogs/issues
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High level of unbilled (DNFB) accounts
Other Major Experience Areas
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Benchmarking/Metrics - not produced/tracked
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Dashboard - not available for leadership
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Report infrastructure limited/fragmented
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Physician engagement -limited/no feedback
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Silo effect with other departments
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Information technology - issues/challenges
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Clinical/Ancillary leadership - no communication
Billing/Followup
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Clean bill rate improvement
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High$/Aging A/R
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High level of account write offs
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Denial Management
Self Pay Collections
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High volume of bad debt
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Limited collection strategy/resources