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Why Do I Need a Billing Assessment?

A Billing Assessment, also called a Revenue Cycle Assessment, is important for any organization, whether small or large, because there are many “red flag areas” that can potentially reduce cash flow, present compliance risks, and impact efficiencies. What’s Involved in a Billing Assessment? From patient demographics, insurance verification, charge entry, coding, electronic claims submission, payment …

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Denials Management

How do Denials Impact my Reimbursement?

Denials impact reimbursement by delayed cash flow, increased accounts receivable days and increased cost to rework the claims.  Knowing the volume of denials and the denial reasons is an important step towards improving the denials process.  Understaffed or high turnover in-house billing teams find it challenging to fit denial management work into their regular workflow.  …

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Surprise Medical Bills

Improving the Patient Payment Experience

Securing patient payment has always been a challenge for healthcare providers. However, higher deductible plans with more patient responsibility have made the patient payment experience of the Revenue Cycle a whole new level of challenging. The key for providers to remember is eligibility. Ensure your staff is trained in two key areas. One, how to …

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Increased Spending

Service Spotlight: Payment Posting and Denials Management

Getting your reimbursement from payors is key to any successful practice. However, ensuring those payments are posted accurately and denials are worked promptly, can not only make a huge difference in your cash flow, but your practice’s overall financial health. Why is timely payment posting so important? When payments are posted within 24-48 hours of …

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RCM

The Future of RCM: Artificial Intelligence

No doubt the pandemic has shifted the revenue cycle model. However, that model had already started to change with payor contracts and fee schedules, higher patient responsibility and deductibles, and a move towards value-based payments. The Revenue Cycle needs an update to deal with the increase in healthcare technology. We see more A.I. being used …

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Potential Changes to Telehealth Visits

The global COVID-19 pandemic has brought an emerging healthcare technology to every-day practice nearly overnight. Two years ago, telehealth was something new that many practices were shying away from. Once the pandemic took over, they became a literal virtual necessity. Before the pandemic, legislation required many telehealth visits to still occur in a medical facility …

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site neutral payments

Site-Neutral Payments Supported by Federal Court

In a ruling last week, a Federal appeals Court ruled that the Department of Health & Human Services (HHS) is authorized to implement site-neutral payments. This is a long-awaited and huge win for independent physician practices. Historically, off-campus clinics attached to a hospital were reimbursed at a higher rate than independent physician practices. This left …

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