Category: Blog

Denials

3 Tips To Manage Claims Denials At ASCs

Three experts on revenue cycle and operations at ASCs gathered at the Becker’s ASC 25th Annual Meeting: The Business and Operations of ASCs conference in Chicago Oct. 19 to discuss how administrators can improve reimbursement per case at their facilities. Here are three pieces of advice they shared on how to avoid claims denials: Be […]
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Bundled Payments Are a Simple Way To End Surprise Billing

Imagine buying a plane ticket, but the fare only covers your seat, the fuel, the gate attendant, and the peanuts. You have to pay the pilot separately. You are sitting on the plane and, unbeknownst to you, the pilot scheduled to fly your plane is delayed and a pilot from another airline takes over. Because […]
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Collections

Cracking The Code Behind The Patient Revenue Cycle

The rules of other consumer commerce sectors somehow do not apply to medical billing. Stop and think about that for a moment. It’s easier to make sense of how much we spend for goods and services such as groceries, clothing, and gasoline because we know how much it costs up front. No smoke and mirrors. […]
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EM-Codes

E&M Flat Rate Reimbursement Delayed to 2021

For 2019 and 2020, we will see no changes to our outpatient, office-based evaluation and management (E&M) services, but things will change come 2021 – that according to the E&M Final Rule released Thursday by the Centers for Medicare & Medicaid Services (CMS). Since 2004, CMS has stated through the Claims Processing Manual that medical […]
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5 Ways To Maximize Collections as The Patient Becomes The Payer

Over the last few years, healthcare has shifted from a standardized, product-centric experience to one that is more personalized. Patients now have access to more information on providers than ever, meaning they have more choice when selecting care they feel will best meet their unique needs. At the same time, patients are taking on more […]
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Are Medicare Advantage Plans Creating Excessive Denials?

MAs are taking advantage of excessive denials to reduce payments to providers. The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently found that between 2014 and 2016, a total of 75 percent of all appealed Medicare Advantage (MAs) denials were overturned, equivalent to roughly 216,000 denials a year. I […]
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Patient-Engagement

Seven Outcomes of Successful Patient Engagement Strategies

There are numerous patient engagement strategies aimed at improving care. What are the outcomes that show these solutions are working? Patient engagement affects every patient interaction across the care continuum. Accordingly, the outcomes that you can expect will come from every area of the organization. When refining targeted outcomes, let metrics be your guide. Measurement […]
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CMS Finalizes 2018 MPFS Payment and Policy Changes - Allzone

CMS Proposal to Reduce Documentation Requirements

CMS proposes to ease burdens on providers. When it comes to the ever-changing Centers for Medicare & Medicaid Services (CMS) agency rules and regulations, one can’t help but be reminded of the classic tune by The Byrds: “to everything (turn, turn, turn), there is a season (turn, turn, turn).” The last several decades have been […]
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