Category: Medical Billing

how-5-steps-transforming-patient-access-saved-20m

How 5 Steps For Transforming Patient Access Saved $20M

  ‘If you can get it right up front, you’re ensuring accuracy, preventing rework, and preventing denials,’ says Alicia Auman, director of patient access at KSB Hospital. Patient access plays a tremendously important role within the revenue cycle, which is why Alicia Auman, director of patient access at KSB Hospital in Dixon, Illinois, has worked […]
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No Surprises Act Notice Requirements: The Good and Bad News for Providers

Surprise billing occurs when patients receive care from out-of-network providers without their knowledge. On July 1, the Biden Administration passed an interim final rule: the first portion of the “Requirements Related to the Surprise Billing Act,” in an attempt to curb excessive costs patients are required to pay in relation to surprise billing. The rule […]
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Gain Insight Into Billing an E/M With OMT

Reducing denials starts with understanding osteopathic manipulation as well as coding and coverage guidelines for this therapy. Is it appropriate to bill an evaluation and management (E/M) service when osteopathic manipulative treatment (OMT) is performed at the same visit? We must address a few key principles to adequately answer this question. I learned quickly, having […]
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Patient Payments Trends To Watch

Device agnostic digital patient intake; buy now, pay later; compassionate billing; and AI-enabled customizable payment plans are four trends that rev cycle leaders should watch as the pandemic rages on. Despite promises of a “hot-vaxxed summer,” the COVID-19 pandemic is raging on, more forcefully in some places than ever before. It’s also continuing to take […]
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CMS Prior Authorization—operational And Financial Impact

CMS has expanded the prior authorization requirement to two new service categories within hospital outpatient department services. The Centers for Medicare & Medicaid Services (CMS) has expanded the prior authorization requirement for two additional hospital outpatient department (OPD) services. Effective with date of service July 1, 2021, CMS has expanded the prior authorization requirement to […]
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Medicare/Medicaid Contracts: When the Contract Can Benefit the Provider

Depending on the clauses, contracts can be your worst enemy or your savior. Today I pose a very important question to you. Do your participation contracts that you sign with Medicare/Medicaid, managed care organizations (MCOs), and Medicare Administrative Contractors (MACs) – do they even matter? Are these boilerplate contracts worth the ink and the paper […]
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New bill aims to boost Medicare access to chronic care services

  New legislation aims to eliminate the cost-sharing requirement for Medicare beneficiaries to get chronic care management services and reimburse providers for 100% of the payment. The legislation, reintroduced Thursday, intends to boost access among seniors to chronic care management services that include creating a care plan and medication reconciliation and adherence. “Chronic health conditions […]
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How 2 Rural Hospitals use charities to help Patients without-of-pocket costs

Outside financial aid might not be the best long-term solution to the national problem of high healthcare costs and inadequate insurance coverage, but two rural hospitals are taking innovative approaches to tapping philanthropic resources to reduce their bad debt and help patients with medical bills. The American Hospital Association’s latest Annual Survey of Hospitals showed […]
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