AppriseMD

AppriseMD welcomes Mr. Jason Klein to its Advisory Board. Mr. Jason Klein is an Executive Vice President and the Chief Financial Officer at HSA Commercial, Inc., a Chicago-based, privately held business. His experience as a CPA, as well as his work with financial policy and tax compliance will be an asset to the AppriseMD Advisory Board.  https://lnkd.in/eHdrtuiy  

AppriseMD salutes the essential role case managers play in utilization review during this National Case Management Week. #CMWeek2024

AppriseMD’s latest case study centers on a patient that was hospitalized for chest pain, and the claim was denied based on unproven medical necessity and a lack of reasonable expectation of hospitalization that crossed two midnights. The denial was rescinded after a peer-to-peer discussion where the AppriseMD physician advisor reviewed the case details with the payer, explaining that both requirements were met. The AppriseMD physician advisor pointed out that cardiology was worried enough to perform a catheterization in the setting of chronic kidney disease, thus doctors suspected a high pretest probability. Read the full case study at https://lnkd.in/gx-Yhkrq #casestudy #medicalnecessity #utilizationmanagement #utilizationreview #denialmanagement

AppriseMD recognized Dr. Victoria Elochukwu Ndubuisi as its the Featured Case Preparation Physician this month. She has consistently demonstrated exceptional dedication, going above and beyond, while maintaining a positive attitude, even when faced with challenges or tight turn-around times. This is the second time this year Dr. Ndubuisi has earned this well-deserved recognition, showcasing her continued excellence and strong work ethic. https://lnkd.in/ePFmYtsW

Thank you to the Northern Suburban Special Recreation Association (NSSRA) for a great Swing Golf Outing! The event supports the foundation's scholarships, transportation, special events and more for NSSRA participants. NSSRA’s mission is to enrich the lives of people with disabilities in partner communities through quality recreation services in the suburbs of Chicago. AppriseMD was proud to be an event sponsor. CEO and founder Franklin E Baumann, MD participated in the tournament along with participants in the NSSRA program. The team members are, pictured from the left, Mr. Keith Garstecki, Dr. Franklin Baumann, Matt L., Jack C., Mr. Dave Schopen and Dr. Steve Stern.

State insurance commissioners have cited 7 payers in 2024 for improper claim denials, slower reimbursements & for the sale of umapproved products. https://lnkd.in/eF4wu2Zh

As the use of AI in healthcare continues to grow, so do the myths, which Becker's Healthcare pointed out. The "use of AI in claim denials" is not a myth though. The increasing use of AI to automatically deny claims without review creates an issue for hospitals and revenue cycle managers struggling to reduce denials. Read more in our compendium, "The Use of AI in Claims Denials."  https://lnkd.in/ev-9ayMx

"A swirl of challenges is looming for Medicare recipients ahead of the annual enrollment period beginning October 15th" according a Becker's Healthcare article published last month.

An American College of Physician Advisors’ recent report concurs with earlier data from AppriseMD partner hospitals that more than half a year after the Centers for Medicare & Medicaid Services’ 2024 final rule 4201-F took effect, many Medicare Advantage Organizations are not complying with the new guidelines. #MAO https://lnkd.in/eDq35mjp

Case preparation physician, Dr. Asad Mehmood was recently recognized by AppriseMD. Dr. Mehmood's extraordinary performance earned him the Featured Case Preparation Physician of the month honors. He is a dependable team player who is both reliable and respectful when working with client hospitals and our team of physician advisors. https://lnkd.in/ePFmYtsW