Category: Blog

10 tips to Squeaky Clean Your Medicare Part-B Claims

10 tips to Squeaky Clean Your Medicare Part-B Claims

Don’t allow preventable error to disrupt your revenue cycle. In order for a claim to be considered clean, it must contain all necessary information for the payer to fully process it without requiring further investigation or development. This includes being submitted within the designated timeframe, passing all necessary reviews, having any required medical evidence or […]
Top 4 Compliance Policies and Procedures You Need to Know

Top 4 Compliance Policies and Procedures You Need to Know

Your healthcare entity is at risk if these elements aren’t part of its compliance plan. As healthcare workers, it’s our responsibility to know and understand that the Office of Inspector General (OIG) expects all healthcare entities to follow and abide by its self-proclaimed seven elements of an effective compliance program. The first element, implementing written […]
CMS Rules for Coding Emergency Department Claims | Best Practices

CMS Rules for Coding Emergency Department Claims | Best Practices

The Centers for Medicare and Medicaid Services (CMS) has consistently authorized hospitals to establish and utilize their own coding guidelines for emergency department facility claims. CMS makes clear that “[a]s long as the services furnished are documented and medically necessary and the facility is following its own system, which reasonably relates the intensity of hospital […]
Revenue Cycle Billing Challenges_ Insights from Patient Experience

Revenue Cycle Billing Challenges: Insights from Patient Experience

To enhance the financial experience of patients, it is crucial to closely examine an organization’s billing procedure. HealthLeaders is joining the celebration of Patient Experience Week from April 23-29 by highlighting the efforts of revenue cycle leaders in establishing a favorable financial experience for patients in their organizations. With a suboptimal financial experience capable of […]
Healthcare Revenue Cycle Strategies to Boost Practice Revenue

Healthcare Revenue Cycle Strategies to Boost Practice Revenue

Insufficient implementation of revenue cycle management (RCM) strategies may result in disorderliness. Conversely, optimizing RCM in conjunction with billing and collection procedures can mitigate the difficulties, leading to amplified revenue for the practice. The Role of RCM in the Healthcare Sector RCM encompasses both the clinical and business aspects of healthcare institutions, linking patient care […]
Why Denials Management is Crucial for Revenue Cycle Leaders – Again

Why Denials Management is Crucial for Revenue Cycle Leaders – Again

Revenue cycle leaders were asked to rank the most time-consuming tasks at their organization, and the results aren’t surprising. 556 chief financial officers and revenue cycle leaders at hospitals and health systems across the United States were asked to rank the most time-consuming revenue cycle tasks at their organizations in a new survey commissioned by […]
Mastering Medical Coding: Strategies To Avoid Revenue Loss

Mastering Medical Coding: Strategies To Avoid Revenue Loss

Medical coding is an essential aspect of healthcare in that it translates diagnoses, procedures, medical services, and equipment into alphanumeric codes. The processes involved in medical coding is complex, however, so errors can often result in payment delays and significant financial losses. The most common errors leading to delays and lost revenue are tracking down […]