Physicians with paid medical malpractice claims are more likely to have at least 1 more claim in the next five years, compared to physicians with none. A new study found “a single prior paid claim was associated with substantial, long-lived, higher future claim risk, independent of whether a physician was practicing in a high- or […]
Using this technology to create the discharge summary is that the output is only as good as the input. A physician advisor once had a terribly unfortunate incident in which a pregnant patient died. This initiated a mandatory investigation by the Ohio Department of Health (ODH). This was one of those imperfect storms in which […]
Error-free medical billing and coding are critical characteristics of a revamped revenue cycle system. Appropriate billing and coding are not only needed in terms of compliance but are also pivotal in bringing down medical claim denials and rejections. When you take a more dynamic approach to your billing and coding operation, you not only get […]
Inflation and pressing household expenses are forcing some people to postpone health needs, an emerging trend that has health experts worried that conditions may only worsen. Megan Swanson has warily watched the erosion of her family’s savings as inflation chips away at a reserve for emergencies. She often postpones any regular doctor’s appointments, including her […]
KEY TAKEAWAYS Denials rose to 11% of all claims last year, up nearly 8% from 2021. Revenue cycle leaders should place their focus on clinical validation denials to help ease the overall denials burden. A key defensive strategy for preventing denials is provider education. Revenue cycle leaders need to understand that clinical validation denials are […]
Medical claims denials are on the rise and continue to be a costly problem for health systems. Unfortunately, the vast majority of providers focus their resources on reactive responses, working to appeal denials and recover payments after denials have already occurred. In a Becker’s Healthcare podcast an expert, discussed the problem of rising denials, why […]
While these activities oftentimes become challenging, they should help in facilitating reimbursement. This month, we’ll dive into the next steps needed for medical practices to take after being credentialed to maximize the chances of receiving reimbursement. The next critical steps after getting credentialed are (1) to conduct eligibility checks for patient visits and (2) get […]
Each year the American Hospital Association (AHA) releases an advocacy agenda focusing on key areas in need of “critical support” for hospitals and health systems, and this year, quite a few key areas will be focused on your revenue cycle. “Hospitals and health systems are dealing with unprecedented challenges as they manage the aftershocks and […]
February may be American Heart Month, but correctly diagnosing and coding cardiac conditions requires healthcare professionals to work hard to get right 365 days a year. Outlining coding guidance for pulmonary hypertension – a rare condition that nonetheless can be particularly deadly, often because it is not diagnosed until it is in advanced stages. It […]
Over 1,500 hospitals reviewed in the report were noncompliant with at least one requirement of the price transparency rule between December 2022 and January 2023. Less than a quarter of hospitals are complying with the hospital price transparency rule over two years after the regulation went into effect, according to a report from PatientRightsAdvocate.org. The […]