Category: Revenue Cycle Management

Professional Fee Revenue Cycle for Better ED Bottom Lines

7 Best Practices to Improve Professional Fee Revenue Cycle for Better ED Bottom Lines

Most healthcare organizations partner with physician services groups for niche coverage. While outsourced medical services are available across all specialties, common areas for external physician support include anesthesia, radiology, wound care, and emergency medicine. However, when outsourced physician services are used, challenges to ensure accurate reimbursement for both components of care—the hospital portion and the […]
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Prevent Billing Errors to Reduce Hospice Claim Denials

Prevent Billing Errors to Reduce Hospice Claim Denials

Effective revenue cycle management can reduce hospice claim denials, particularly those associated with billing or documentation errors. In addition to slowing down payments or losing revenue, submitting inadequate or incomplete required written documentation is a sure-fire way to bring surveyors or auditors to a hospice’s doorstep. As regulators increasingly fix their eyes on the hospice space, providers […]
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5 Tips for Making Prior Authorizations Less Burdensome

5 Tips for Making Prior Authorizations Less Burdensome

A 2016 study in the Annals of Internal Medicine found that for every hour physicians spend in direct face-to-face clinical time with patients, they spend nearly two additional hours on desk work. According to the American Academy of Family Physicians (AAFP), this administrative burden is one of the primary complaints of its members, and prior authorizations top the list of […]
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Optimizing Revenue Cycle Management

Optimizing Revenue Cycle Management For 2020

With patients seeing higher medical bills than ever and healthcare costs continuing to rise, healthcare organizations need to stay on top of the revenue cycle to ensure they can capture payments and be prepared for changes in 2020. Speaking at the annual meeting of the American Health Information Management Association (AHIMA) in Chicago, Cassi Birnbaum, […]
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CMS Finalizes How It Will Cut Medicaid DSH Payments

CMS Finalizes How It Will Cut Medicaid DSH Payments

The Senate passed a continuing resolution that would temporarily stop the implementation of Medicaid DSH payment cuts until Nov. 22, 2019. CMS on Monday finalized a rule that will reduce Medicaid Disproportionate Share Hospital (DSH) payments by $4 billion next year and $8 billion a year until fiscal year 2025. The new final rule will implement Medicaid DSH payment […]
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Root Causes Linked to Claim Denials

Root Causes Linked to Claim Denials

Three revenue cycle tips are provided to reduce denied claims. Claim denials represent millions of dollars in lost and delayed net reimbursement annually. According to the American Medical Association (AMA), cost estimates of inefficient healthcare claims processing, payment, and reconciliation top out at $210 billion per year. Claim denials are so common, they’ve become a fixture […]
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Hospitals Looking Beyond EHR to Improve Revenue Cycle Performance

Hospitals Looking Beyond EHR to Improve Revenue Cycle Performance

Over 60 percent of hospitals and health systems are not realizing optimal value from their EHR system, causing the organizations to collaborate with other vendors and outsourcing companies to improve revenue cycle performance. That was a finding from a new Navigant analysis based on an executive survey conducted by Healthcare Financial Management Association (HFMA), which polled 108 […]
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Hospitals to Assume Risk in Value-Based Care Models

Verma Presses Hospitals to Assume Risk in Value-Based Care Models

Hospitals assuming downside financial risk under value-based care models is the key to lowering healthcare costs and improving quality, CMS believes. CMS Administrator Seema Verma urged hospitals on Tuesday to accept new value-based care models and price transparency requirements or face greater administrative burden, less competition, and lower reimbursement rates under Medicare for All. “Our choices are […]
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