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Category \ Revenue Cycle Management


In early September, the Centers for Medicare and Medicaid Services (CMS) and Wisconsin Physicians Service Insurance Corporation (WPS) announced a significant data breach affecting nearly 950,000 Medicare beneficiaries. This incident, stemming from a vulnerability in specific software used for file … Keep Reading
In today’s digital healthcare landscape, it can be difficult to track when and where claim payments are being processed and delivered. Providers having better insight into historical processing can give trends that inform when the organization will receive payments, as … Keep Reading
Though the concepts of palliative care have been around since the inception of the hospice care delivery model, palliative care continues to be mostly undefined from regulatory and payment structure perspectives. Palliative care is provided by a specially trained team … Keep Reading
With the implementation of the Notice of Admission (NOA) at the beginning of 2022, we have seen some issues occur with each Medicare Administrative Contractor (MAC) and their acceptance of the NOA. These issues should be reviewed at each of … Keep Reading
Despite the negative connotation, a denied claim is not always a bad thing. Inconvenient, sure. Confusing, sometimes. However, it is when the denied claim results in an unpaid claim that the situation turns negative. Too many home health organizations lose … Keep Reading
As companies across the world focus on closing out the year strong, we should also be mindful of the new year and immediately start planning. Use of a built-in revenue cycle management solution can help improve operational efficiency, but there … Keep Reading
The undefined, in-between stage of a new business forming its vision and roadmap can be challenging in any industry. In the highly regulated healthcare sector, this stage can confuse even the most established provider. Palliative care currently has no conditions … Keep Reading
The rise in palliative care comes with an increase in palliative care billing, a financial element not widely known since not all palliative care services are billable. Coding requirements for palliative care change frequently as its popularity grows. Billing for … Keep Reading
A good patient outcome is the direct result of a good plan of care. This plan is only beneficial if it is developed around confirmed patient diagnoses. Complete and accurate coding of patient diagnoses is the foundation for care provided … Keep Reading
Increasing your patient count is not the first step toward becoming more profitable. That starts by examining your current billing processes, identifying areas that are inefficient and pinpointing steps that are dragging down reimbursement times. Selene Baldonado, director of revenue … Keep Reading
Medical coding bridges the connection between providers and payers with a universal set of codes for all diagnoses, procedures, services and equipment. Coding directly affects revenue generated for an episode. There are several factors to consider to capture the precise … Keep Reading
When we think of medical coding and billing, most imagine these as two completely unrelated functions. Medical coding is associated with the assignment of codes to medical diagnoses, while billing is more commonly thought of as a revenue cycle management … Keep Reading

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