by admin | Dec 30, 2019 | Billing Terms, Codes, Denials Management, Patient Billing
Changes coming in 2021 2020 looks to be a transition year on the payment front, as many programs and changes expected to go into effect this year have been delayed until 2021. These include new CMS-created primary care models and a streamlining of evaluation and...
by admin | Sep 4, 2018 | Denials, Denials Management, Health Care Finance, Hospital Revenue Cycle, Medical Billing, Revenue Cycle KPI's
Two metrics important to the discussion of creating claims most likely to be immediately reimbursable are Clean Claim Rate (CCR) and First Pass Rate (FPR). Though sometimes confused for one another, these are separate statistics, each worthy of optimization....
by Ed Slingsby | Jul 2, 2017 | Denials Management, Health Care Finance, Hospital Revenue Cycle, Revenue Cycle Performance
Read this report from the Advisory Board on ways you can improve revenue cycle performance now. Hospitals leaving $22M on the table Share...
by admin | Dec 12, 2016 | Denials, Denials Management, Medical Necessity, Medical Necessity
Preventing Medical Necessity Denials KAREN HOPPE Although all hospitals must comply with a Medicare requirement that services provided to beneficiaries are reasonable and medically necessary for treatment and diagnosis, the criteria may be inconsistent among...
by Ed Slingsby | Dec 9, 2016 | Billing Terms, Coding, Edits
NCDs (National Coverage Determinations) and LCDs (Local Coverage Determinations) are decisions by Medicare and their administrative contractors that provide coverage information and determine whether services are reasonable and necessary on certain services offered by...
by admin | Jan 1, 2015 | Denials Management, Financial Statistics, Revenue Cycle KPI's, Revenue Cycle Performance
Click to access PNC%20SW%20Ohio%20HFMA%20Presentation.pdf Using KPIs to Accelerate Revenue Cycle Performance Click to access PNC%20SW%20Ohio%20HFMA%20Presentation.pdf Measurement • We’ve all heard it: you can’t manage what you don’t measure. – Measurement aids in...
