The healthcare landscape is undergoing a significant transformation, shifting from a fee-for-service model to value-based care (VBC). This patient-centric approach emphasizes quality of care, patient outcomes, and cost-effectiveness. For healthcare providers to thrive in this evolving environment, optimizing revenue cycle management is paramount, and at the heart of this lies efficient and accurate medical coding […]
Accounts Receivable (AR) days directly impact cash flow and overall financial health. The longer a claim sits in AR, the more challenging it becomes to collect revenue, leading to cash flow disruptions, operational inefficiencies, and reduced profitability. Therefore, it’s crucial for businesses to actively work to reduce AR days and improve their financial performance. With […]
After appealing the courts’ ruling on vacating a piece of arbitration within the No Surprises Act, HHS asks the court for a hold on its plea. HHS recently requested for a hold on its appeal of a Texas federal court ruling vacating parts of the independent dispute resolution (IDR) process in the surprise billing interim […]
Undercoding, or reporting a lesser service than was performed and documented, is sometimes employed as a defensive strategy to stave off claims denials or audits. But, undercoding can make a provider an outlier, and may create consequential patient care, compliance, and financial liabilities. For example: Undercoding Leaves Money On The Table, Driving Down Provider Reimbursement […]