Tag: Emergency Department

CMS Rules for Coding Emergency Department Claims | Best Practices

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 […]
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Strategies to Mitigate Shrinking Reimbursement in Emergency Medicine

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 […]
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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 […]
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