Tag: Healthcare RCM

How 5 Steps For Transforming Patient Access Saved $20M

‘If you can get it right up front, you’re ensuring accuracy, preventing rework, and preventing denials,’ says Alicia Auman, director of patient access at KSB Hospital. Patient access plays a tremendously important role within the revenue cycle, which is why Alicia Auman, director of patient access at KSB Hospital in Dixon, Illinois, has worked so […]
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The payment posting process: An important step in your practice’s medical billing cycle

COVID-19 has stretched our nation’s healthcare resources to the brink, also having a significant impact on the economic health of medical practices. New challenges because of the pandemic have forced practices and health systems to take a closer look at their financial health. More specifically, providers have been seeking to identify new ways in which […]
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Prime Healthcare hospitals cut ties with UnitedHealthcare, citing low reimbursement

Prime’s New Jersey hospitals will continue to honor the rates and services in the agreements until the end of the cooling off period. The decision impacts Saint Clare’s Health in Denville, Dover and Boonton, Saint Michael’s Medical Center in Newark, and Saint Mary’s General Hospital in Passaic. Dr. Sonia Mehta, regional CEO and chief medical […]
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5 Steps To Revenue Cycle Succession Planning Success

It’s more important than ever for revenue cycle leaders to think seriously about succession planning as baby boomers begin to retire and the revenue cycle increasingly requires more specialized skills, says PeaceHealth’s senior enterprise director of HIM, coding, and CDI. “Everyone’s replaceable,” says Cassi Birnbaum, senior enterprise director of HIM, coding, and CDI at PeaceHealth […]
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2022 IPPS Final Rule Boosts Hospital Reimbursement

On Aug. 2, 2021, the Centers for Medicare and Medicaid Services (CMS) posted the fiscal year (FY) 2022 Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) final rule. Effective Oct. 1, the final rule updates Medicare payment policies and quality reporting programs for inpatient and long-term care hospitals and […]
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Leaked CMS Report Targets Medicare Noncompliance at CA Hospital

A leaked CMS report targeting HCA Healthcare-owned Good Samaritan Hospital in California warns the hospital to fix Medicare noncompliance issues or risk termination. A leaked CMS report put HCA Healthcare-owned Good Samaritan Hospital in California at risk of program termination by October if they fail to fix Medicare noncompliance issues that resulted in patient harm. […]
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Dos And Don’ts For Managing Inpatient-to-observation Status Downgrades

In the newest episode of the HealthLeaders Revenue Cycle Podcast, Charlie Brown, MBA, a former hospital executive and vice president of revenue cycle at a consulting firm, provides actionable steps for mitigating status downgrades and dealing with them effectively to ensure that organizations receive the full reimbursement for the services they provided. In his more […]
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