Critical access hospitals face structural barriers in utilization management that urban systems do not. A Physician Advisor’s view on where the gaps actually are.
Why Rural Hospitals Are at a Disadvantage in Utilization Management Read More
One missed utilization review can cost a hospital $4,500 to $8,000. More headcount won’t fix that. Here’s what actually will.
Medicare Advantage Post-Acute Denials Are Feeding Hospital Revenue Leakage Read More
One missed utilization review can cost a hospital $4,500 to $8,000. More headcount won’t fix that. Here’s what actually will.
Utilization Review Isn’t a Nursing Function. It’s a Revenue Function. Read More
How scrutiny on the two-midnight rule impacts your hospital. Here’s how to stay ahead of it before year end.
Short Stay Compliance: Stay Off CMS’s Radar Read More
A well-timed status upgrade funds 20 automated reviews. Here’s the math and the mechanics behind it.
Turns Manual Reviews Into Real-Time Revenue Protection Read More
Hospital revenue cycle teams are facing three main challenges: ongoing staffing shortages, more denials, and stricter compliance checks. Manual, case-by-case utilization review can’t keep up.
Q4: The Time to Fix Hospital RCM Pressure Points Read More
A successful utilization management program can make key performance metrics look worse before they look better. Learn why a declining CMI, rising AR days, and more denials don’t always signal revenue cycle problems and how net revenue reveals the bigger picture.
When Good Utilization Management Makes Your Numbers Look Bad Read More
CMS proposes removing 637 more procedures from the Medicare IPO list in CY 2027. See what it means for documentation and status determination.
The End of the Medicare Inpatient-Only List Read More
Inaccurate patient status creates revenue and compliance risk. Discover why healthcare leaders must prioritize automation projects that improve real-time determinations.
Why Projects Targeting Accurate Patient Determinations should be an Executive IT Priority Read More
How Certus Radar™, powered by Brundage Group, transforms clinical revenue cycle performance.
Three Reasons Hospitals Need Automation in 2026 Read More
Stay compliant after Medicare’s Sept 2025 short stay review shift to MACs.
You Need Certus Radar™ to Stay Off the Radar Read More
Brundage Group is HITRUST certified—delivering secure, compliant solutions that protect your data and strengthen the clinical revenue cycle.
HITRUST Certified: Our Approach to Secure Revenue Cycle Integration Read More
Recover hidden revenue with Certus Radar™—real-time oversight, 24/7 reviews, and expert UM support. Get a free data analysis today!
How to Recover Hidden Revenue with Utilization Management Read More
Why do conflicts over the two-midnight rule persist? Discover how clearer documentation, alignment with Rule 1599F, and streamlined processes can reduce denials and enhance care coordination. Learn actionable strategies to close documentation gaps and improve outcomes for both patients and hospitals.
Two-Midnight Rule: Greater Understanding Yields Better Results Read More
Certus Radar™ combines expert automation and real-time analytics to optimize utilization management, ensuring accurate patient status and timely escalations to prevent revenue leakage.
Unlocking Compliance, Continuity, and Revenue Potential with Certus Radar™ Read More
Hospital inpatient utilization management (UM) is crucial in the healthcare industry, ensuring hospital resources are used appropriately…
How Hospital Inpatient Utilization Management Shields Against Claim Denials Read More
Utilization Management, focusing on quality patient care and cost-effectiveness, is a vital cog in the wheel for hospitals. Coordinating the appropriate use of resources and ensuring patients get the right level of services at suitable times it shapes the landscape of health management systems globally.
The Key to Effective Utilization Management Read More
Utilization management plays a pivotal role in healthcare. Utilization management promotes high-quality patient care by evaluating the necessity, appropriateness, and efficiency of health services. It’s essential for hospitals, as it helps curb unnecessary expenses while ensuring optimal use of resources. Embracing this proactive approach can dramatically improve patient outcomes.
What is Utilization Management and Why It’s Important in Healthcare Read More
You’re delving into a crucial topic in healthcare management: understanding and managing hospital length of stay. Grasping this subject can help to optimize resources, improve patient outcomes, streamline workflow more efficiently, and reduce undue burdens on the health system.
A Comprehensive Guide to Understanding and Managing Hospital Length of Stay Read More
Learn about the specific outcomes of the emergency department pilot program during…
Optimizing Coordination Among Mid-Revenue Cycle Stakeholders Read More
“Upcoding” remains a common mechanism of improper payments. “Healthcare compliance…
What Is Your Data Telling Medicare? Read More
As a former manager of clinical documentation integrity (CDI) and utilization…
Is There a Blind Spot in Your Mid-Revenue Cycle? Read More
The diagnosis of Healthcare-Associated Pneumonia (HCAP) is clinically out of date…
Healthcare-Associated Pneumonia: Why You Should Not Diagnose It Read More
The National Association of Healthcare Revenue Integrity (NAHRI) recently asked our…
Take control of Medicare Advantage denial challenges Read More
I just returned from the ACPA National Physician Advisor Conference where I met…
Expand the role of the physician advisor to break down silos Read More
