Healthcare IT Blog

Waiting on authorizations while beds stay full? See how ADS supports enterprise health systems and rural hospitals from one record. A patient is medically ready to move to inpatient rehab. Your case manager is on hold with a Medicare Advantage plan, waiting on an authorization. The bed stays full. The ED backs up behind it. When the answer finally arrives, it's a denial.

Running inpatient status through three disconnected systems? See how ADS supports enterprise health systems and rural hospitals from one record. A patient sits in observation for 36 hours. Your physician is sure the stay needs inpatient care. Your case manager is on the phone with a Medicare Advantage reviewer who disagrees. Three weeks later, the claim comes back denied, and your team starts an appeal from scratch.

Every October 1, the same thing happens to practices that didn't prepare. A code your team has used for years stops working, the claim bounces, and nobody notices until the denial report runs. This year's ICD-10-CM update is smaller than most, which makes it easy to assume you can skip the prep. That assumption is exactly what causes the denials.

The healthcare industry's pivot towards value-based care (VBC) is particularly transformative for behavioral health, redefining how services are provided and compensated. This shift from traditional fee-for-service models, where providers are paid for the quantity of care, to models that prioritize the quality and outcomes of care represents a significant evolution in healthcare delivery. Advanced Data Systems Corporation (ADSC) stands at the vanguard of this shift, equipping behavioral health providers with the necessary tools and insights to thrive under these new conditions. Here’s an expansive look at the essential nature of value-based care in behavioral health.