Caitlin Wells Salerno knew that some mammals — like the golden-mantled ground squirrels she studies in the Rocky Mountains — invest an insane amount of resources in their young. That didn’t prepare her for the resources the conservation biologist would owe after the birth of her second son. Wells Salerno went into labor on the […]
‘If you can get it right up front, you’re ensuring accuracy, preventing rework, and preventing denials,’ says Alicia Auman, director of patient access at KSB Hospital. Patient access plays a tremendously important role within the revenue cycle, which is why Alicia Auman, director of patient access at KSB Hospital in Dixon, Illinois, has worked so […]
COVID-19 has stretched our nation’s healthcare resources to the brink, also having a significant impact on the economic health of medical practices. New challenges because of the pandemic have forced practices and health systems to take a closer look at their financial health. More specifically, providers have been seeking to identify new ways in which […]
Surprise billing occurs when patients receive care from out-of-network providers without their knowledge. On July 1, the Biden Administration passed an interim final rule: the first portion of the “Requirements Related to the Surprise Billing Act,” in an attempt to curb excessive costs patients are required to pay in relation to surprise billing. The rule […]
Reducing denials starts with understanding osteopathic manipulation as well as coding and coverage guidelines for this therapy. Is it appropriate to bill an evaluation and management (E/M) service when osteopathic manipulative treatment (OMT) is performed at the same visit? We must address a few key principles to adequately answer this question. I learned quickly, having […]
Device agnostic digital patient intake; buy now, pay later; compassionate billing; and AI-enabled customizable payment plans are four trends that rev cycle leaders should watch as the pandemic rages on. Despite promises of a “hot-vaxxed summer,” the COVID-19 pandemic is raging on, more forcefully in some places than ever before. It’s also continuing to take […]
CMS has expanded the prior authorization requirement to two new service categories within hospital outpatient department services. The Centers for Medicare & Medicaid Services (CMS) has expanded the prior authorization requirement for two additional hospital outpatient department (OPD) services. Effective with date of service July 1, 2021, CMS has expanded the prior authorization requirement to […]
Depending on the clauses, contracts can be your worst enemy or your savior. Today I pose a very important question to you. Do your participation contracts that you sign with Medicare/Medicaid, managed care organizations (MCOs), and Medicare Administrative Contractors (MACs) – do they even matter? Are these boilerplate contracts worth the ink and the paper […]
On July 1, the Department of Health and Human Services (HHS), Department of Labor, and Department of the Treasury (Departments) jointly issued interim final rules (IFR) implementing certain aspects of the No Surprises Act (Act), which was signed into law on December 27, 2020, as part of the Consolidated Appropriations Act, 2021. The purpose of […]
Surprise billing compliance will have impacts throughout the revenue cycle, so preparation now is key to meeting the January 1st deadline. A prohibition on surprise billing is coming at the start of next year and federal agencies have started to release what surprise billing compliance will look like. These new compliance requirements will have a […]