Effective July 1, 2020 Illinois Medicaid transitions Non-Institutional Provided Services (NIPS) to be billed on institutional claims.
Welcome to the second installment of our Expect More From Your Claim Scrubber series! If you missed the first article all about how efficientC differentiates itself from other claim scrubbers on the market, you can find it here. In this article, we’re diving into the importance of working with a claim scrubbing partner who prioritizes denial prevention by focusing on first pass yield.Read More
If you ever doubted that interactions between patients and your registration and billing staff are important to reimbursement, consider how the Affordable Care Act ties reimbursement to patient satisfaction.
Here’s how:Read More
Rural hospitals, as defined by their geographic location, have an essential role in our nation’s healthcare system, as well as in the communities they serve. Unfortunately, trends in healthcare reimbursement and factors outside their control have put many of them into difficult financial situations.
In recent years, many of the 60 million Americans living in rural communities have watched helplessly as their only local source of healthcare disappears.Read More
In a perfect world, your claims would leave your business office “clean” and be paid promptly.
No denials, no delays, and no reductions in payment. But the world of health care providers and payers is not perfect; nor is it simple.
Increasing the number of claims that get paid on the first submission takes time, effort, and quality control. It is possible, however, to apply strategies that help reduce avoidable claim denials – those that could be prevented by your organization – and take a critical step toward improving revenue cycle management.Read More
As a revenue cycle consultant for Zimmerman & Associates in the early 90s, I served as an analyst for the HARA report. For those of you who started your career after it was in circulation or don’t recognize the name, HARA stood for Hospital Accounts Receivable Analysis. At the time, it was the industry-leading publication that discussed healthcare billing best practices and trended major KPIs. Which brings me to my reason for this article - the GDRO benchmark (Gross Days Receivable Outstanding) for a superior performing hospital at the time was anyone reporting 60 days or less.Read More
In our previous Revenue Cycle Matters posts, we discussed the importance of clearinghouse and claim scrubber partners as part of an effective revenue cycle management strategy. We also highlighted the benefits of focusing on first pass yield and clearinghouse features that support positive collection outcomes.Read More
Benchmarking the effectiveness of a clearinghouse can be done in many ways and most clearinghouses use clean claim rate, as the success criterion making them the best choice for your revenue cycle.Read More
High deductible plans and increasing copays and coinsurance are driving patient balances up. This trend is unlikely to change.
Almost 40% of employer-sponsored healthcare insurance plans require annual deductibles of $1000 per year, and that number keeps rising as employers scramble to reduce their costs while still offering insurance to their employees.Read More