Category: Medical Billing

How To Manage Accounts Receivable

How To Manage Accounts Receivable

Sound accounts receivable (A/R) management is integral to the financial health of a medical practice. The ability to maximize collections and profitability depends on it. Thus, it’s important that practices know what processes they can implement to ensure a smooth-running AR operation. David Norris, MD, MBA, an anesthesiologist in Wichita, Kan. and author of The […]
Automating Revenue Cycle Management Improves Patient Experience

Eight Things You Should Do Now To Clean Up Your Outpatient Billing

Tips for improving outpatient billing, coding and CDI. In moving from inpatient clinical documentation improvement (CDI) to outpatient CDI, I have been discovering some unique educational pointers. I know we are all very busy, so let’s just dive right into it. Doctors and coders, you should not have diagnoses that are mutually exclusive to one […]
Medicare Reimbursement Rates for Kidney Care-1

CMS Finalizes 2020 Medicare Reimbursement Rates for Kidney Care

The final rule for the CY 2020 End-Stage Renal Disease (ESRD) Prospective Payment System will boost Medicare reimbursement to encourage dialysis innovation. CMS last Thursday finalized a rule that will bump the bundled Medicare reimbursement rate for end-stage renal disease (ESRD) providers by $4.06 in 2020 and create a transitional add-on payment adjustment for certain new dialysis […]
AI Clinical Documentation Improvement Tools

Providers Ready for AI Clinical Documentation Improvement Tools

88% of providers are eager to implement clinical document improvement technology that leverages AI, and 93% believe the systems can streamline document creation. Forty-four percent of healthcare organizations already use artificial intelligence (AI) in one form or another, and more hospitals are looking to apply the technology to coding and clinical documentation improvement, a recent […]
Reducing Patient Billing Disputes

How Hospitals Avoid or Reduce Patient Billing Disputes

CMS’ reworked the Merit-based Incentive Payment System, to simplify reporting requirements for providers in its 2020 Physician Fee Schedule Quality Payment Program Final Rule.Patient billing disputes result in more work for hospital staff and can potentially stand in the way of timely payment for services. However, many organizations are making efforts to avoid or reduce […]
Outpatient Proposals

2020 Outpatient Proposals: 5 Rules You Should Know From CMS

Hospital and health system executives should monitor these proposals for provisions that will affect their organizations’ operations. The 2020 annual rule cycle has been active for CMS. Several proposals in the outpatient prospective payment system (OPPS) proposed rule is controversial, although there is at least one provider-friendly change. Here’s a roundup of five regulatory rules […]
Professional Fee Revenue Cycle for Better ED Bottom Lines

7 Best Practices to Improve Professional Fee Revenue Cycle for Better ED Bottom Lines

Most healthcare organizations partner with physician services groups for niche coverage. While outsourced medical services are available across all specialties, common areas for external physician support include anesthesia, radiology, wound care, and emergency medicine. However, when outsourced physician services are used, challenges to ensure accurate reimbursement for both components of care—the hospital portion and the […]
Developing A Hospital Claim Validation Strategy To Prevent Denials

Developing A Hospital Claim Validation Strategy To Prevent Denials

A comprehensive hospital claim validation strategy that prevents denials and improves efficiencies hinges on the right blend of retrospective and pre-bill reviews. The time to strengthen hospital compliance programs through claim validation is now. According to healthcare finance and information management leaders surveyed by HIMSS Media, clinical documentation and coding were the revenue cycle processes most vulnerable […]