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Three Revenue Cycle Challenges Caused by COVID-19

July 22, 2020

...and How to Solve Them

The healthcare industry is acclimating to a world in which COVID-19 persists. As regulations and mandates are regularly being introduced, providers are facing problems affecting the revenue cycle.

Here are three common challenges we've seen:

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News - Illinois Medicaid NIPS Billing Update

June 05, 2020

Effective July 1, 2020 Illinois Medicaid transitions Non-Institutional Provided Services (NIPS) to be billed on institutional claims.

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Our Telehealth Advice: Don't Worry Answers Are on the Way

May 20, 2020

Health care providers are encountering several problems stemming from the increase in telehealth usage, many of which are directly tied to the COVID-19 pandemic.

Many physicians are now working remotely as clinics have been partially or fully closed during the pandemic. These clinics need to do what they can to maintain profitability during this time.

The Office of Civil Rights (OCR) has relaxed some requirements and waived penalties for HIPAA violations against health care providers. Relaxing HIPAA requirements allows for the use of “in good faith” technologies such as FaceTime or Skype during COVID-19. Currently there is no expiration date to these new guidelines.

With OCR’s new waiver, it is easier to get the face-to-face technology set up the “new” telehealth way. What is not so easy, is making sure that services rendered translate to income for providers.

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Adoption of Telehealth Services Surging

May 04, 2020

It’s been said that now is boom time for telehealth in the US, but that may be an understatement.

For decades, telehealth services have been beneficial in rural regions because they reduce barriers to care for people who live far from specialists and other services. Apart from that, they were not widely used elsewhere. 

Over the years, however, the use of telehealth services has been increasing steadily, and the method of delivery has evolved from telephone to videoconferencing and other technologies.

Today, the spread of the COVID-19 virus has created a surge in demand for telemedicine because it is perfect for providing virtual services to patients.

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Powerful Analytics Drive Performance Improvement

April 20, 2020

Welcome to the third installment of our Expect More From Your Claim Scrubber series. If you missed Part 1 and Part 2, make sure you check them out!

We’ve been sharing all the details on how efficientC differentiates itself from other clearinghouses & claim scrubbers on the market.

Today, we’re shifting the focus to denial analytics and how one Wisconsin-based health system has been able to achieve a first pass yield of 90-95% with the help of efficientC.

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Focus on First Past Yield Supports Denial Prevention

March 13, 2020

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.

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Expect More from Your Clearinghouse - The efficientC Difference

February 17, 2020

As a healthcare leader in 2020, your bottom line is largely dependent on your ability to get claims paid accurately and on time—contributing to predictable cash flow and less costly re-work by billing staff. So keep the New Year going strong by taking steps to improve that bottom line.

The first step?

Begin by taking a closer look at your clearinghouse, which is arguably the most important technology in the revenue cycle. It is responsible for transmitting claims to payers, but even more importantly, it should have powerful claim scrubber technology. A clearinghouse that submits inaccurate claims, while touting a high clean claim rate, will create more follow-up work and increase operating costs.

Don’t take your clearinghouse for granted.

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Plan for Revenue Cycle Success in 2020

January 22, 2020

 

Setting Your Revenue Cycle Goals

The best hedge against problems down the road is a solid plan. Even the most well-run organizations can benefit from goal setting at least annually. Giving yourself and your staff a set of goals to strive for provides you with benchmarks that help you determine if you are succeeding.

To realize your goals, you need to know how to set them. Goal setting is a process that starts with careful consideration of what you want to achieve, followed by specific steps, and some hard work.

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Increase Satisfaction and Reimbursement by Knowing What Patients Want

December 11, 2019

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: 

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Increasing First Pass Payment Success in Your Revenue Cycle

September 10, 2019

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.

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