EFT = Electronic Funds Transfer Benefits of EFTs ■Funds are available faster ■Administrative costs are reduced ■Accounting Department can reconcile receivables ■Contribute to the Paper Reduction Act
Electronic Data Interchange (EDI)
EDI= Electronic Data Interchange EDI helps provide quick efficient exchange of healthcare information •EDI provides access to HIPAA compliant transactions ■270/271 Eligibility Response in real time from the CMS data center ■276/277 Claims Status Inquiry within one day from EDI
Medicare Acronyms
Medicare Acronyms searchable list Rural Health Clinics (RHC) Federally Qualified Health Clinics (FQHC) End Stage Renal Dialysis (ESRD) Fee-For-Service (FFS) Medicare benefits •QIO –Quality Improvement Organizations •COBC –Coordination of Benefits Contractor •QIC –Qualified Independent Contractor •WIC –Western Integrity Center •CERT –Comprehensive Error Rate Testing Contractor •RAC –Recovery Audit Contractor
AHCCCS plans to increase the number of hearings
The AHCCCS Office of Administrative Legal Services, in cooperation with the Arizona Office of Administrative Hearings, intends to significantly increase the number of administrative hearings scheduled each month to resolve a backlog of payment disputes filed by healthcare providers. http://www.azahcccs.gov/commercial/Downloads/ClaimsClues/2012/ClaimsClues_March2012.pdf Over a period of several months, beginning April 2012, AHCCCS plans to increase the number […]
Medicare Summary Notice (MSN)
MSN= Medicare Summary Notice (MSN) http://www.medicare.gov/navigation/medicare-basics/understanding-claims/understanding-claims-overview.aspx If you get a Medicare-covered service, you’ll get a Medicare Summary Notice (MSN) in the mail every 3 months. The notice shows all your services or supplies that providers and suppliers billed to Medicare during the 3-month period, what Medicare paid, and what you may owe the provider. This […]
Multiple Procedure Payment Reduction (MPPR) on Certain Diagnostic Imaging Procedures
MPPR=Multiple Procedure Payment reduction. 100% of most expensive procedure, and other similar procedures reduces by a certain percentage if done by same physician on same date http://cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM7442.pdf
Safety Net Denver Health System Improves Revenue Cycle Performance
Great article about Hospital Revenue Cycle enhancement Despite a challenging payer mix, Colorado’s Denver Health and Hospital Authority has maintained its commitment to serving patients while generating $29 million through revenue cycle improvements over the past five years. Much of this success can be attributed to adoption of formal performance management processes. By The Denver […]
Executive Health Resources (EHR)
Founded in 1997, Executive Health Resources (EHR), The Physician Advisor Company™, is the leading provider of medical necessity compliance solutions to more than 2,000 hospitals and health systems across the country. Endorsed by the American Hospital Association and Peer Reviewed by the Healthcare Financial Management Association, EHR’s solutions are delivered through expert Physician Advisors who […]
Hospital Revenue Cycle report
The trends in revenue cycle management for short-term acute care hospitals for the past five years (FY06-10) are not encouraging. A basic role of hospital revenue cycle management is to measure how well a hospital maximizes the amount of patient revenue billed and how quickly it collects that revenue. An effective way to analyze patient […]
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