MCG and Denials Management

Amanda Martin, a Clinical Documentation Improvement Specialist with Wickenburg Community Hospital (a critical access hospital in Arizona) discusses how her facility uses MCG as a common clinical decision support language with its government and commercial payers to mitigate denials. By leveraging the MCG Indicia solution in their utilization management and clinical documentation improvement efforts, the Wickenburg team achieved a 64% reduction in denials in just 1 year, and zero denials for their inpatient acute unit. She also discusses what she likes about the MCG solution including the Obs vs. Inpatient criteria and level of care tools. The robust supporting citations in the MCG care guidelines also help guide her hospital's clinical decisions when writing appeal letters. Learn more: www.mcg.com/ho...