Northwell Health executives share practical, in-depth strategies to help revenue cycle leaders prepare for additional COVID-19 surges and other emergencies. Health system leaders around the country can look to systems like Northwell Health in New York for guidance about how to best prepare their own revenue cycles for a possible second wave of COVID-19 cases as states ease restrictions […]
Our goal was to develop a single source of truth that is user-friendly, dynamic, and easily accessible,” said Jeannette Wood, vice president of revenue cycle management for Privia Health. A rapidly changing situation like the COVID-19 pandemic calls for a dynamic solution for tracking billing and coding changes for virtual services from different payers […]
Financial indicators, staffing, and leadership are three key factors emergency departments should prioritize for effective revenue cycle management during the COVID-19 crisis. At the start of the year, emergency departments (EDs) across the country began to prepare for an expected surge of patients infected with COVID-19, altering revenue cycle management and operational strategies. By March, […]
The early eruption of the coronavirus prompted the federal government to urge a widespread halt of elective procedures in hopes of slowing the viral spread. For radiologists, this caused a massive decline in routine exams, which can result in a 40 percent-to-60 percent loss in revenue. Evolving health policies and industry environments keep revenue cycle […]
Prior authorizations, or prior approvals, are strategies that payers use to control costs and ensure their members only receive medically necessary care. The cost-control process requires providers to acquire advance approval from payers before delivering specific services or items for a patient. Payers are increasingly using prior authorizations to lower their costs and improve care […]
New patient evaluation and management (E/M) claims are being denied when the patient was previously seen by a specialty physician assistant or specialty nurse practitioner on staff. This is happening when another provider of a different specialty in the same multi-specialty group sees the patient for the first time and bills a new patient E/M […]
Hospital billing departments coordinate health plan benefits every day. Typically, coordination of benefits (COB) is aided by patient registration workflows that gather basic demographic and health insurance information. But what if a patient gets hurt on the job or in an automobile accident? How well does your organization collect the information needed to coordinate […]
The American Medical Association issued a checklist for the transition to fundamental changes in evaluation and management (E/M) services, a medical coding process in support of medical billing which practicing healthcare providers must use to be reimbursed by Medicare, Medicaid programs or private insurance. The checklist provides a guide for physician practices, which already are […]
In addition to patient billing and policy, healthcare M&A and workforce diversity will also be major trends going into the new year, according to PwC’s Health Research Institute. Patient billing, policy and regulation, healthcare mergers and acquisitions, and workforce diversity will be some of the top priorities for provider organizations in 2020, predicted researchers at PwC’s Health […]
Resolving credit balances can bring your organization out of the red and into the green. 6-Step Checklist to Recover Revenue Adjustments are correct Patient cost-sharing amounts are correct No duplicate payment postings Payments went to correct payers No charge entry errors Corrected claims are accounted for You may have encountered this situation: Your boss assigns […]