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Want to fast track your reimbursement cycle? Different insurances differ in the time they take to process claims. Target easier insurance carriers with specific focus and see the change. One carrier which centers should look at is Medicare. It has a straightforward submission process coupled with fewer hassles for reconciling denials.
A claim can be denied even before a patient is seen by the physician. Essentially, the revenue cycle begins when a patient calls in to schedule an appointment. As simple as it may sound, the primary cause of most pre-visit denials is the lack of a checklist. What we don’t find in centers after centers, is the execution of the following list before every patient visit:
Patient-centric healthcare delivery is the most important aspect of delivering quality healthcare. Thanks to advanced technology, patients are more informed and want to be more involved in their health planning and decision-making. The new legislation and regulations (e.g. Meaningful Use of EHRs, Patient Protection and Affordable Care Act (PPACA or Obamacare) point towards quality of service and patient satisfaction. Unfortunately, patient-provider encounters have become very mechanical. Exceptional providers genuinely care about the well-being of patients. Patient experience is just as vital as the billing process itself.
More than 50% of the medical fraternity has transitioned towards adopting electronic health records. As the second stage of Meaningful Use certification is upon us, let’s take an overview of what’s happening in the Meaningful Use EHR program.
There are claims that get paid and then there are those that are denied. What signals a claim to be passed over? Patient eligibility, correct coding, timely submission, etc. – all can determine if the claim will be paid. Practices often don’t realize the importance of referrals in getting the claim paid. If you miss a referral, the claim is most certain to be denied. Also, the more patients referred to you, the better your reimbursements.
Patient collection is an integral part of the revenue cycle management, yet it is also the task medical practices enjoy the least. Patient deductibles are in general increasing. According to a study, 22.7 percent of people under the age of 65 with private health insurance are enrolled in high deductible health plans. According to the McKinsey report, 36 percent of patients have a balance of 60 days or more past due. So bad debts are on a rise as well. Determining the actual amount of money due and finding effective, yet cheaper ways to recover it is what becomes tricky.
On a typical day, you check your schedule and plan your day accordingly. The first patient walks in, checks out. Second patient walks in, checks out. You call in for the next patient. Guess what, the patient never made it to the appointment. The patient is a NO SHOW without prior notice. The rate of no show visits varies from 10% to 60% across the country. That’s a very big number to consider, adding to lost revenue and time.