Capturing accurate patient acuity not only enhances reimbursement and quality scores but also significantly reduces the likelihood of payor denials. In 2023, the typical Sandiola hospital client successfully recaptured an average of $400,000 in reimbursement.
CARDIFF, Calif., Feb. 15, 2024 /PRNewswire/ — Sandiola focuses on securing rightful reimbursement for independent, community hospitals for their patient care services. By providing both First and Second Level Clinical Documentation Integrity (CDI) reviews along with chart prioritization workflow technology, Sandiola ensures patient acuity is accurately captured and hospitals receive full reimbursement. Furthermore, our thorough efforts act as a safeguard, making it challenging for commercial payers to downgrade or deny claims, thereby improving the financial stability of our partnering hospitals.
Since 2010, roughly 150 rural hospitals have shuttered and hundreds more have slashed services, leaving a growing number of America’s 60 million rural residents in health care deserts. While these areas make up 20% of the US population1 they only have 9% of the country’s doctors2 and half of this population lives at least 60 minutes from the closest hospital with trauma care services.3 Rural America is the primary source for inexpensive and safe food, affordable energy, and clean drinking water4 in the US and is foundational for a vibrant economy. Ensuring rural America has access to high quality care is crucial, and a strong CDI program is vital for the success of independent community hospitals.
“Costs have been increasing significantly and payments, particularly from commercial insurance plans, have not increased correspondingly with that,” said Harold Miller, president and CEO of Center for Healthcare Quality and Payment Reform.
Rural hospital closures “will lead to longer emergency department wait times, farther distances to travel for care, and ‘care deserts’ for services like maternity care and behavioral health. For others, the change will be more severe with tragic examples where people can’t get to the next nearest hospital for care,” said Carmela Coyle, president and CEO of the California Hospital Association.5
“We focus on providing independent, community hospitals with the expertise they need to receive the reimbursement they deserve. By helping independent, community hospitals thrive, we also help their surrounding community thrive. And by doing so, we assist our customers with ensuring their communities have access to high-quality, compassionate health care.” – Vinnie Whibbs, CEO of Sandiola.
About Sandiola
Sandiola empowers independent, community hospitals to improve financial performance by addressing CDI staffing challenges and capturing patient acuity correctly. Sandiola operates on a contingency basis, ensuring no cost if additional reimbursement is not secured. Whether your hospital has a CDI team or needs one, we customize our services accordingly.
Our rapid 30-day implementation, real-time training, and seamless integration showcase our commitment to collaborative success. Sandiola’s CDI/Coding specialists, dual-credentialed from ACDIS and AHIMA, improve acuity capture, quality scores, and documentation.
Choose Sandiola for financial improvement and top-tier customer service. Explore our innovative approach at sandiola.com or connect with us on LinkedIn.
Schedule a 15-minute call today to learn more.
SOURCES
1 https://en.wikipedia.org/wiki/Rural_areas_in_the_United_States#:~:text=Rural%20areas%20in%20the%20United%20States%2C%20often%20referred%20to%20as,)%2C%20live%20in%20rural%20America
2 Rosenblatt, R. A; Hart, LG (November 1, 2000). “Physicians and rural America”. Western Journal of Medicine. 173 (5): 348–351.
3 https://en.wikipedia.org/wiki/Medical_deserts_in_the_United_States
4 https://theconversation.com/rural-america-matters-to-all-americans-69756
5 https://www.chiefhealthcareexecutive.com/view/one-in-five-california-hospitals-face-risk-of-closing-report
SOURCE SANDIOLA
