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Reimbursement Problems!
Is your Practice Analyzing KPIs to Determine Loopholes in RCM?
If you wish to keep a track of your revenue cycle, you need to keep analyzing KPIs such as A/R days, claims processing and patient access quality. Analyzing these KPIs against industry benchmarks will help you identify loopholes in your revenue cycle.
Industry Facts loopholes in RCM
  • A/R days for high-performance hospitals are 30 days or less and for low-performance hospitals A/R days are 60 and above
  • It has been observed that between 5-25% of payment for physicians is either denied or delayed due to coding errors and lack of denial management
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Efficient Practice Management
equals to Higher Revenues!
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ICD 10 Dual Coding – Is it too much to handle?
If you thought ICD-9 will be a thing of the past after 1st October 2015, the answer is no. For a certain period, medical practices will have to use old as well as new code set when filing claims for payment.
Industry Facts Dual coding
  • CMS will not be accepting claims that have ICD-9 as well as ICD-10 codes. Since the use of both code sets in one claim will not be accepted, practices will have to split a claim in some cases
  • As stated in AHIMA’s FAQ on ICD-10, a dual coding system is fraught with difficulties and this system has the potential to undermine the healthcare industry’s data infrastructure
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