Effective RCM Strategy to Increase Reimbursements

The Healthcare Financial Management Association (HFMA) defines Revenue Cycle Management (RCM) as all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue. Revenue cycle management (RCM) is the financial process related to a patient’s clinical encounter. According to HFMA, a basic role of RCM is to measure how […]

Increase your Practice Collection by Educating Patients

Current fact suggests, nearly 6 in 10 patients either rarely or never received an estimate of out-of-pocket costs before they received treatment. As per a survey report from TransUnion Healthcare, 75 percent of patients mentioned that they can play better if they receive pre-treatment estimates of out-of-pocket costs well in advance. The healthcare experts agree […]

How to Boost A/R Productivity for Success of Revenue Cycle during Pandemic?

Are you thinking that revenue flow is interrupted due to high accounts receivable? Of course, you need to boost A/R productivity for the Success of Revenue Cycle but you aren’t the only healthcare professional to face revenue loss but you can make a difference particularly during the pandemic. Insurance companies are obliged to pay healthcare […]

What provider should know about transition to Medicaid Managed Care?

Managed Care plays important role in the delivery of healthcare and it is used to describe a health insurance plan or health care system that coordinates the provision, quality, and cost of care for its enrolled members. Traditionally States have utilized a fee-for-service (FFS) payment system to cover enrollees but now states are also making […]

How Providers can improve telehealth for COVID-19?

Healthcare providers implemented telehealth for COVID-19 pandemic widely in the US. According to 2019 Health Center Program Data, 43% of health centers were capable of providing telemedicine (it is a part of telehealth), compared with 95% of the health centers that reported using telehealth during the COVID-19 pandemic. While the largest increase in the use […]

What you should know about Denial Code CO 50?

Denial Code CO 50 means that the payer refused to pay the claim because they did not deem the service or procedure as medically necessary. It is a very popular denial code and the sixth most frequent reason for Medicare claim denials. According to a CMS, It is observed that 30% of claims are either […]

Non-ST elevation (NSTEMI) ICD-10 Codes for Myocardial Infarction

NSTEMI, Type 1 vs Type 2 MI: Why Accurate ICD-10 Coding Directly Impacts Revenue and Compliance Myocardial infarction (MI) documentation errors are no longer just clinical inaccuracies. In today’s reimbursement environment, misclassifying Type 1 MI, Type 2 MI, demand ischemia, or assigning incorrect NSTEMI ICD-10 codes — including Non-ST Elevation (NSTEMI) ICD-10 codes — can […]

Common challenges facing by physicians in 2021

Today physicians whether they own their practice or are employed by a hospital or larger health system are facing many challenges in the day-to-day routine. These common challenges include “How to use the EMR efficiently and getting paid”, overburden with administrative requirements, staffing, burnout, etc. despite their devotion to the practice of medicine and the […]

Avoiding Medicare/Medicaid Crossover Claims Rejections

If your Medicaid crossover claims are rejecting it may be due to the address you have on file with Medicare and Medicaid. When Medicare crosses over your claim to Medicaid, address fields like Master address and Pay-to (or remit address) are submitted. If Medicaid does not have the same addresses in their file, Medicaid will […]

Updates to the IRF Quality Reporting Program

CMS recently announced the proposed rules for the ‘Inpatient Psychiatric Facility Prospective Payment System and Inpatient Rehabilitation Facility Prospective Payment System’ for FY 2022. This proposed rule would update the prospective payment rates for IRFs for Federal FY 2022. The proposed FY 2022 IRF Prospective Payment System rule would boost Medicare payments by 1.8%, or […]

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