If there’s one thing healthcare providers can agree on, it’s that prior authorization management is a heavy administrative burden and only growing heavier. Decades ago, it was created to ensure care standards continuity, improve safety and regulate costs but has become an unwieldy process filled with manual tasks and roadblocks that dilute the original intent. […]
Cold antibody hemolytic anemia is a rare autoimmune disorder characterized by the premature destruction of red blood cells by autoantibodies at temperatures of approximately 0 to 10 degrees Celsius. Q: What is the difference between cold, hot, and mixed type autoimmune hemolytic anemia, as described by 2021 ICD-10-CM codes D59.11-D59.13? A: ICD-10-CM code category D59.- (acquired […]
The future potential of telehealth hinges on how it’s reimbursed. Virtual care may be popular among patients, but if providers can’t get paid for their services, it’s unlikely they’ll be able to continue to provide them. The government has signaled its support for reimbursing some telehealth services, at least in the short term. The Centers […]
In today’s competitive environment, creating the ultimate “patient experience” will truly differentiate your surgery center and is paramount to building a successful and growing ASC. To create this experience, a patient should be treated with care, respect and competence in each and every interaction with your staff, your processes, your technology and your surgeons. This […]
As we near the fourth quarter of 2020, HBI has begun to receive an influx of questions from revenue cycle leaders who want to know what others are doing to comply with the CMS price transparency rule going into effect January 1, 2021. There are two overarching requirements hospitals will need to comply with: Publicizing […]
CMS provided clarification on submitting inpatient claims for patients diagnosed with novel coronavirus (COVID-19) without a positive viral test, in an update to MLN Matters SE20015 released September 11. Earlier this year, the CARES Act increased the MS-DRG weighting by 20% for a COVID-19 diagnosis. Although the CARES Act doesn’t specify that the diagnosis must be supported by a […]
The Covid-19 pandemic is transforming how physicians practice medicine and bill for it. Physicians who take a consumer-oriented approach to their billing cycle may adapt the best, says John Behn III, MPA, president of Stroudwater Revenue Cycle Solutions and a principal of Stroudwater Associates, a national healthcare consulting firm based in Portland, Maine. “We’ve seen […]
Practices have been creative during COVID-19 to ensure safe patient access: Telephone visits. Curbside immunizations. Drive-up virus testing. Even checking patients in for their in-office visits while they wait in the car. However, each of these scenarios poses one significant challenge: Collecting copayments and coinsurance. “With COVID-19, you’ve got to find ways to meaningfully engage […]
In COVID-19’s wake, providers’ financial recovery will be crucial yet daunting. U.S. hospitals and health systems stand to collectively lose $36.6 billion between March and June 2020 alone. Physician practices also face serious financial challenges as they recoup revenues that declined up to 55 percent and patient volume that decreased 60 percent. Amid these hardships, telehealth has emerged as a […]
More Medicaid and self-pay patients, fewer radiologists, and a greater need for efficiency should prompt radiology practices to optimize revenue cycle management. Declining volumes and revenues during the COVID-19 pandemic could spell big trouble for many radiology practices unless the providers refocus revenue cycle management efficiency and effectiveness for a post-pandemic world. The COVID-19 pandemic […]