Outpatient care has become a cornerstone of modern healthcare, thanks to technological advancements, patient preferences, and cost-effective treatment models. As outpatient services expand, so do the administrative and financial complexities behind the scenes. Revenue Cycle Management (RCM) for outpatient care is no small feat — it involves managing patient scheduling, insurance verification, coding, billing, and […]
In the intricate dance of healthcare administration, few steps are as frustrating and resource-intensive as denials management. Every rejected claim represents lost revenue, increased administrative burden, and potentially delayed or denied care for patients. In today’s challenging healthcare landscape, marked by shrinking margins and increasing regulatory complexities, a proactive and efficient approach to denials management […]
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 […]
Healthcare providers before reeling down the effect of the extended period of misfortune due to COVID-19 were additionally affected by pretentious impact and rising cost of healthcare supplies. RCM leaders are currently focused on two central themes: safeguarding their revenue and maximizing efficiency with limited resources. Unfortunately, the effects of the great resignation have resulted […]
KEY TAKEAWAYS Denials rose to 11% of all claims last year, up nearly 8% from 2021. Revenue cycle leaders should place their focus on clinical validation denials to help ease the overall denials burden. A key defensive strategy for preventing denials is provider education. Revenue cycle leaders need to understand that clinical validation denials are […]
On April 1, your revenue cycle will have additional diagnosis code options to further capture social determinants of health. The CDC just released upcoming changes to both the ICD-10-CM diagnosis code set and the official coding guidelines. The new changes include 42 diagnosis code additions, seven deletions, and one code revision. All changes will go […]
The patient financial experience and No Surprises Act are top of mind for revenue cycle leaders as we move into 2023. As hospitals try to navigate the COVID-19 crisis, inflation, labor shortages, and rising expenses, organizations are going to finish out the year in the red, according to the latest National Hospital and Physician Flash […]
The spotlight is on your revenue cycle’s coding team as COVID-19 reporting sheds light on a multitude of post-acute conditions brought on by the virus. A recent study published in the Journal of the American Medical Association Network Open found that between October 1, 2021, and January 31, 2022, providers used ICD-10-CM code U09.9 (post-COVID-19 […]
The American Medical Association (AMA) says the 2023 CPT code updates emphasize its efforts to reduce administrative tasks. The AMA released the calendar year 2023 CPT code set, which builds on the AMA’s efforts to reduce administrative tasks in medicine, according to a recent press release. The CPT code update contains 393 changes, including 225 […]
CMS released the fiscal year (FY) 2023 inpatient prospective payment system proposed rule with proposals for new calculations for FY 2023 rate setting. Although CMS is proposing to use FY 2021 data for FY 2023 Medicare Severity Diagnosis-Related Groups (MS-DRG) rate setting, the agency wants a modified methodology to account for the historical and potential […]