The number one priority of management, executive, and ownership level business is learning when and how to delegate responsibility. When it comes to revenue cycle management, the evolving healthcare industry almost requires that medical professionals take full account of their administrative capacity. Although keeping this aspect of business in the house may seem like a […]
AHA said that the 2.7 percent Medicare reimbursement update for home health agencies does not accurately reflect the financial challenges that home health agencies have faced during the pandemic. The American Hospital Association (AHA) has urged CMS to reconsider the Medicare reimbursement update for home health agencies proposed in the Calendar Year 2023 Home Health […]
Healthcare costs continue to rise in this country. Healthcare spending totaled $3.8 trillion in 2019, $11,582 per person. In 2028, it projects that spending will rise to $6.2 trillion, or $18,000 per person. These increases are happening at the same time the COVID-19 pandemic revealed systemic inequities in health equity, and how difficult it is […]
MGMA report shows value-based contracts account for $30,922 per provider The Medical Group Management Association released a report looking at the proliferation of value-based contracts and how quality metrics tie-in to revenue. The report, 2022 MGMA DataDive Practice Operations, shows that revenue from value-based contracts accounted for varying amounts of total medical revenue in 2021 […]
Hospitals are increasingly utilizing locum tenens physicians, advanced practice providers (APPs), and telehealth services to address staffing shortages. The Innovation & Flexibility: Journey to Sustainable Healthcare Report reflects data from 129 healthcare administrators representing a range of facility types and sizes. The COVID-19 pandemic exacerbated hospital staffing shortages as many clinicians faced burnout and […]
More than half of economists agree that the U.S. economy is headed for a downturn. Contrary to popular belief, the healthcare sector has never been recession-proof. Reports indicate that the healthcare industry is affected later in a recession and has a longer recovery period. Compared to other healthcare facilities, like hospitals and emergency rooms, independent […]
A major revision of the Current Procedural Terminology (CPT) Evaluation and Management (E&M) Guidelines for Office and Outpatient Visits (O/O Visits), Split/Shared Visits, and Critical Care Time billing was implemented Jan. 1, 2021. You would think that all office-based providers would have been made aware of this and changed their documentation accordingly, but there is […]
Improving clinical documentation quality, leveraging technology, and educating providers are key ways hospitals improve medical coding compliance in a value-based world. Medical coders are typically behind the scenes of patient care, analyzing records, selecting codes for billing, and managing patient data. But to a revenue cycle expert with over 20 years of coding experience at […]
In the dynamic realm of medical billing, the persistence of denied claims poses a significant challenge for providers. Research indicates that an alarming portion of claims – exceeding 10% – face initial denial by insurance companies. This leads to revenue loss, wasted administrative efforts, and frustration for both providers and patients. A robust denial management […]
Merging front and backend functions, leveraging data, collecting payments upfront, and automating prior authorizations are key to healthcare revenue cycle management excellence. “There is always room for improvement” should be healthcare revenue cycle management’s mantra. Declining claims reimbursement rates, the shift to value-based purchasing, and evolving health policies keep revenue cycle leaders constantly seeking new […]