Category: Revenue Cycle Management

COVID-19 is Upending the Revenue Cycle, COVID-19 Pandemic, Social Distancing, Remote Coders, Healthcare Revenue Cycle, Virtual Care, Low-acuity visits, Novel Coronavirus

3 Ways COVID-19 Is Upending the Revenue Cycle

The pandemic crisis is disrupting the revenue cycle, including the revenue ramifications of cancelling elective procedures. The global COVID-19 pandemic has sent the entire world into turmoil, including negatively affecting the U.S. economy, causing a ripple effect down to healthcare organization revenue cycles. Many elements of this crisis are already changing the revenue cycle, from […]
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Mastering Revenue Cycle Management

Mastering Revenue Cycle Management

Doctors are fond of complaining that they didn’t go to medical school in order to practice business, but independent physicians do spend much of their time on their practices’ finances. That requires mastering revenue cycle management (RCM), the financial process practices use to administer all the functions associated with claims processing, payment, and revenue generation. […]
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Medicare Reimbursement for COVID-19

CMS Releases Medicare Reimbursement Details for COVID-19 Tests

Medicare reimbursement for COVID-19 tests will be about $36 for the CDC test and $51 for those created in house or by other entities. Following the development of new billing codes, CMS is now letting clinical laboratories know how much they will receive in Medicare reimbursement for COVID-19 testing patients. CMS emailed providers last week […]
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common revenue cycle issues

3 Twists on Common Revenue Cycle Issues

Denials, automation, and surprise billing are perennially tricky & common revenue cycle issues, but new twists on those topics add an extra layer of complexity. When it comes to revenue cycle management, a handful of common revenue cycle issues are nearly always a struggle, year after year. For instance, denials, automation, and surprise billing are […]
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COVID-19 in healthcare revenue cycle

How COVID-19 Is Impacting the Healthcare Revenue Cycle

COVID-19 is creating unique healthcare revenue cycle challenges around billing and coding, patient financial responsibility, and resource allocation. As entire nations encourage their populations to stay inside to avoid COVID-19, healthcare providers are more active than ever in response to the outbreak of the novel coronavirus. This activity is having a significant impact on the […]
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Hospital Price Transparency

Key Opportunities For Hospitals To Boost Margins In The Era Of Price Transparency

About 60 million Americans live in rural areas and depend on local hospitals for care. In 2019, a record 18 rural hospitals closed, bringing the total closures since 2010 to 124, according to the Cecil G. Sheps Center for Health Services Research. With almost 700 more rural hospitals at risk of shutting, the need for strategies to boost […]
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chiropractic manipulative therapy code denial

E&M Denials When Billed With Chiropractic Manipulative Therapy: What to Do

Question: Why do my Evaluation & Management (E&M) codes keep getting denied when I bill them in conjunction with spinal manipulation? I have been receiving increasing inquiries regarding the denial of Evaluation and Management (E&M) codes 99201-99215 when billed with chiropractic manipulation. It appears to be happening on a wide scale, so I want to address […]
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Healthcare Price Transparency Rule

New Healthcare Price Transparency Rule – The Best, Worst, and Most Realistic Case Scenarios

The American Hospital Association has filed a lawsuit to block the rule. On Nov. 15, 2019, the Trump Administration proposed a new healthcare price transparency rule that would basically require hospitals to explain how much a medical service would cost before a patient receives treatment. This rule is due to become effective in January 2021. The […]
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