Tag: Revenue Cycle Management

Understanding 2021 Changes in Emergency Medicine Reimbursement

Understanding 2021 Changes in Emergency Medicine Reimbursement

  Emergency medicine groups face several changes this year, including a new federal ban on surprise medical billing, updates to the Medicare reimbursement formula, changes to the CMS MIPS program, and new billable services. Below is a summary of these changes provided by the experts at Brault Practice Solutions. Federal Ban on Surprise Medical Billing […]

Scale, Efficiency Key to Provider Success in 2021 and Beyond

The COVID-19 pandemic has permanently changed the healthcare business model, causing providers to rely more on scale and efficiency to maintain financial stability in 2021 and beyond. At least those are the strategies industry leaders at Providence and UW Health are implementing to adapt to a more virtual, leaner environment as the pandemic continues, health […]

ICD-10-CM Coding For Autoimmune Hemolytic Anemia

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 […]
CMS Revises Billing Instructions for Inpatient Covid-19 Claims

CMS Revises Billing Instructions for Inpatient Covid-19 Claims

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 […]
Take a Consumer-Oriented Approach to Your Billing Cycle

Take a Consumer-Oriented Approach to Your Billing Cycle

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 […]
Nine Tips for Collecting Patient Balances

Nine Tips for Collecting Patient Balances

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 […]
3 Elements Needed For The Revenue Cycle of The Future

3 Elements Needed For The Revenue Cycle of The Future

The COVID-19 pandemic has proven that fast, meaningful change is both possible and necessary for healthcare revenue cycles to keep up with a changing world. But to make truly meaningful change within the revenue cycle, the industry will need to embrace even more changes, such as payer partnerships, greater automation, and standardization across payers. Payer-provider […]
Optimizing Self-Pay Collection to Aid Patients, Revenue During COVID-19

Optimizing Self-Pay Collection to Aid Patients, Revenue During COVID-19

Healthcare is the industry most at-risk during the coronavirus (COVID-19) pandemic. Providers are on the front lines of response efforts. At the same time, the financial implications of the pandemic are also creating significant revenue cycle challenges, putting providers even more at risk during the pandemic. Individuals are postponing non-emergency care for many reasons, from […]