Tearing Down the Walls of Revenue Cycle Silos

Data evolution is forcing revenue cycle silos to crumble. And that's a good thing.

Best practices for resolution of medical accounts: an overview

Implementation of new best practices for medical account resolution will: Help patients gain a clear understanding of what to expect in the account resolution process Enable providers to identify and resolve revenue cycle issues Improve the payment process for patients and providers alike

IMs, HINNs: more than just a chore

The Important Message from Medicare (IM), advising patients of their right to appeal their discharge, should be issued correctly or your hospital could be fined or lose the ability to receive reimbursement from Medicare. IMs should be given as close as possible to admission but no later than two days after admission. If patients remain in the hospital for two additional days, they must receive a second copy. Use the IM as an opportunity to discuss the discharge process with patients and families and to alert them to the expected discharge date. When patients appeal, drill down and determine the reason they appealed and use your finding to improve your discharge process.

Part A to part B rebilling: understanding the rules in a changing environment

Under a recent CMS ruling, hospitals that have been denied payment for Medicare Part A services have the option to submit follow-up claims to Medicare Part B for some of these denied services. A CMS proposed rule threatens to remove that option by imposing barriers to the rebilling of claims denied under Part Afor payment under Part B. By commenting on the rule, hospitals may be able to persuade CMS to reject the proposed rule and, instead, adopt a policy similar to that in the ruling. Should CMS decide to finalize the rule, hospitals can use their comments in efforts either to convince Congress to enact statutory changes that would mandate expanded Part B rebilling or to challenge the final rule in litigation.

Achieving revenue integrity in hospitals and health systems

The Bellevue Hospital sought to improve its performance in three areas-days in accounts receivable (A/R), denials, and charge capture-to enhance revenue integrity. Results included the following: A 30-percent reduction in days in A/R. A nearly 200 percent increase in bad debt collections. A more than $1.6 million reduction in denials write-offs. An improvement in net revenue of more than $1 million.

Are you ready for audits

Audits can cost your practice thousands--if not millions--of dollars. Protect yourself with internal audits to ensure compliance.

Developing a revenue integrity improvement plan

A revenue integrity plan should address five key areas: Accuracy of patient information. Verification of payer information and policies. Accuracy of documentation. Processing of claims. Accuracy of payment.

Best practices for self-pay collections

Hospitals can improve their ability to collect on patient accounts by tailoring collection efforts to four segments of patients: Segment A: Patients with a high likelihood of payment and low account balances; Segment B: Patients who have high original balances, but also a high likelihood of payment; Segment C: Patients who have large balances and low expected collection rates; Segment D: Patients with low balances and low expected collection rates.

Spinning straw into gold: smarter bad debt management

To improve its bad debt management, Meridian Health focused on these three areas: Automatic rules-based workflow to control compliance with policies and procedures. Agency management and monitoring. Use of analytic technologies to manage recoveries.

Hatch hunts for hospitals. Minnesota is now the main stage in U.S. debate over uninsured billing as a third group of hospitals sign pacts with state officials

Minnesota has become the main stage in the debate over uninsured billing. Forthe third month in a row, state authorities have signed agreements with hospitals to expand discount programs and limit debt-collection efforts. The latest deal means about 75% of admissions there will be covered by such pacts. "We saw this as a positive response to a major public challenge," said Terence Pladson, left, of CentraCare.