Navigating Complex Coding Requirements to Minimize Denials
Revenue streams are in a state of flux in today’s changing healthcare landscape. However, at least one constant remains: quality medical coding is a critical factor in maintaining a healthy revenue stream. Around 42% of claims are denied because of coding issues, emphasizing the importance of precise coding practices. It is important to ensure your […]
Shearwater Health Welcomes New CHRO to the Executive Team
Jen Bales joins Shearwater Health Executive Team as Chief Human Resources Officer (CHRO) Nashville, TN, October 10, 2023 – Shearwater Health, a global leader in clinical solutions for the healthcare industry announced today that Jen Bales has joined the executive team as chief human resources officer (CHRO). Bales is a seasoned human resources professional with […]
Shearwater Health Invests in Bedside Nurses with Launch of STAR Program
Among the many disruptions the healthcare industry has experienced in recent years, one of the most crucial is also one of the most hands-on and profound: an all but crippling shortage of nurses. In fact, even before the pandemic hit in 2019, the International Council of Nurses (ICN) reported a staggering global shortage of 30.6 […]
Risk Adjustment Coding: Addressing Accuracy, Quality and Productivity
About the Client Organization A world-class academic healthcare system with three highly regarded hospitals, physician practices, home hospice care, and various other support services located in the Eastern U.S. Challenge The health system had previously used a single revenue cycle vendor for risk adjustment coding. With the arrival of COVID, the organization decided it needed […]
Workflow Innovation for Remote Patient Monitoring
The growth of wearable devices has brought great potential for improved, more proactive healthcare, especially in the area of sensor-enabled remote patient monitoring (RPM). According to research, remote patient management services and tools are expected to reach over 70 million U.S. patients by 2025. The challenge is that activating the data needed for effective RPM […]
Revenue Cycle Management and Coding Services
About the Client Organization A leader in homecare, palliative, and hospice services committed to enhancing the quality and consistency of healthcare delivered at home. With locations in Florida, Illinois, Michigan, and Pennsylvania, the organization serves patients and their families across seven states. Challenge The Home Health Patient-Driven Groupings Model (PDGM), which was released on January […]
Shearwater Health Named a Leader in Clinical and Care Management Operations – National Ranking Announced by Everest Group
Nashville, TN, August 22, 2023 – Shearwater Health, a global leader in Clinical Process Outsourcing (CPO®) announced today that it has been recognized as a Leader in Everest Group’s PEAK Matrix® Assessment for Clinical and Care Management (CCM) Operations. The report evaluated the CCM capabilities of 15 service providers and positioned them as Leaders, Major […]
Shearwater Health Named Innovator in Clinical Process Business Services National Ranking Announced by Avasant
Nashville, TN, August 8, 2023, Shearwater Health, a global leader in Clinical Process Outsourcing (CPO®) announced today that it has been recognized as an Innovator in Avasant’s Clinical Services Business Process Transformation 2023 RadarView™. The Clinical Services Business Process Transformation 2023 RadarView™ highlights key supply-side trends in the clinical services space from Avasant’s viewpoint. The […]
Improving Patient Care with Coding
The healthcare industry has been no stranger to shortages of qualified workers over the few years, and the coding workforce is no exception to this trend. There is a need for more medical coders across the U.S., making it increasingly more challenging to find skilled and credentialed coders who can execute the specific type of […]
Health Insurance Claims Analysis
A current trend in the Healthcare industry is the increasing volume of inpatient claims denied by payers based on lack of medical necessity. While Medicare offers detailed payer categories compared to other providers, they also reject the highest number of shares. However, from 2021 to 2022, the inpatient claim denial saw a rise of 18.5% […]