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Saisystems Health Blog


Three Ways to Avoid ER Visits

By: Samantha Manns, Marketing Specialist

Does a 24.7% decrease in emergency room visits sound unattainable? We would think so too, if we weren’t familiar with Saisystems Health’s revolutionary care management programs.

As hard as it may be to believe, ER visits are avoidable.

You just have to know what steps to take.

If you’re struggling with this goal, Saisystems Health has a solution to reduce repeat ER visits for your chronic and oncology patients.

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Who is Who on the Care Team

By: Sheryl Riley, RN, OCN, CMCN, Director of Clinical Programs

In the past decade, much has changed in regards to care management. As we have previously discussed, all care managers used to be nurses, serving a multipurpose role for the health plan or insurer.

However, in today’s health world, the role of a traditional care manager no longer exists.

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Three Steps to Balance Billing Hospice Patients with Integrity

By: Sathishkumar Perumal, Revenue Cycle Account Manager

Billing Medicare for hospice can be a complicated process, but imagine being patient in hospice and receiving a bill. Although many physicians adjust patient balances, not all follow this practice and some patients receive statements.

This can be upsetting and confusing during such a difficult time if the patient and their family are under the impression that Medicare covers 100% of hospice. So, how do you bill appropriately while considering the possible effects on your patients?

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How Downcoding Decreases Your Dollars

By Ramesh Leelasankar and Soundar Raja, Delivery Managers

As a provider, you may have struggled to evaluate the benefits of downcoding. Believe it or not, CMS data reveals that some physicians are coding four levels below to avoid payor audits. Comprehensive Error Rate Testing (CERT) reports that physicians lose more than $1 billion in revenue every year due to this practice.

So, is downcoding worth the risk?

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