Utilization Management, Industry Regulations, Revenue Leakage and Workflow

Course overview

This 1-hour recorded session explores how utilization management challenges, industry regulations, and inefficient workflows contribute to revenue leakage across healthcare organizations. Learners will examine the complexities of holding Medicare Advantage plans accountable to the Medicare Two-Midnight Rule and identify utilization review process gaps that impact financial performance. The session also highlights observation length of stay as a critical utilization review metric and its role in ensuring compliant, efficient, and sustainable care delivery.