Tag: Emergency Department

Rules for Coding Emergency Department

CMS Rules for Coding Emergency Department Claims | Best Practices

The Centers for Medicare and Medicaid Services (CMS) has consistently authorized hospitals to establish and utilize their own coding guidelines for emergency department facility claims. CMS makes clear that “[a]s long as the services furnished are documented and medically necessary and the facility is following its own system, which reasonably relates the intensity of hospital […]
Medicaid-Expansion-Boosts-Financial-Performance-of-Providers

Medicaid Expansion Boosts Financial Performance of Providers

Medicaid expansion improved financial performance for healthcare providers and was associated with lower uncompensated care costs and higher revenues. Medicaid expansion has positively impacted healthcare providers by boosting financial performance and resulting in payer mix improvements, data from the Kaiser Family Foundation (KFF) found. All but 11 states have expanded Medicaid eligibility as of January […]
Reimbursement Loss

Strategies to Mitigate Shrinking Reimbursement in Emergency Medicine

Emergency departments are under intense pressure to do more with less, and drilling down into clinical and operational data can provide opportunities to offset decreasing revenues Many emergency providers are starting to find themselves caught within a perfect storm, with pressure from reduced reimbursements building steadily across all payer types. Medicare payments for emergency care have effectively […]
Emergency Department Revenue Cycle

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 […]