Sweeping Changes for E/M Coding Are on the Way – What Do They Really Mean?
/ Posted in GeBBS Healthcare Solutions, Inc.Come 2021, outpatient evaluation and management, or more commonly known as E/M coding is getting a massive overhaul and will considerably impact how care is documented and reported. This past August, the Centers for Medicare & Medicaid Services (CMS) confirmed that several previously announced changes to E/M guidelines and pay rates for outpatient and office …
Verify, Verify, Verify – Why Insurance Verification is Money in the Bank
/ Posted in GeBBS Healthcare Solutions, Inc.Successful, accurate medical billing and reimbursement begins with ensuring every patients’ insurance information is accurately captured and thoroughly verified – ideally before the start of any encounter. That’s because failing to do so can result in payment delays or more likely claims denials – which can have a significant and negative impact on reimbursement and …
Struggles of Streamlining Scheduling in Healthcare – How to Make it Happen
/ Posted in GeBBS Healthcare Solutions, Inc.These days, if you want to schedule a haircut, vehicle repair, DMV appointment, or cable service – chances are, you can do it online with the click of a button. On the other hand, scheduling a hospital procedure or a routine doctor’s appointment might require multiple phone calls, voicemail exchanges, and frustrating phone trees before …
Precarious Problems with Prior Authorizations
/ Posted in GeBBS Healthcare Solutions, Inc.Patients and providers alike suffer the pain and financial implications of prior authorizations, also referred to as prior approval, pre-authorizations, or pre-certifications. A red tape-laden approval process required by government and commercial payers, prior authorizations are often required for numerous treatment options such as hospital admissions, procedures, surgeries, diagnostic testing, imaging services, therapies, and even …
When it Comes to Satisfaction, the Experience is Everything
/ Posted in GeBBS Healthcare Solutions, Inc.It’s true that in nearly every industry, the experience is everything. Failing to meet customer expectations is most certainly the demise, as the Amazon effect and consumerism have pushed people to expect more for less without delays or frustration. Yet, in healthcare – still many patients face delays and frustration at every step of their …
When it Comes to Payment, Accuracy is Everything
/ Posted in GeBBS Healthcare Solutions, Inc.In the consumer world, you pay for what you get. Unfortunately, in healthcare, it doesn’t exactly work that way. The complex world of healthcare billing means that patients and providers alike are often left confused with what items they’re being charged or for what services they’ve been paid. While there are several reasons for this, …
Top Trends in Provider-Payer Relationships
/ Posted in GeBBS Healthcare Solutions, Inc.We all know Americans spend too much on health care. Per capita estimates for 2017 indicate the US government spend per person is $10,209. That’s in addition to what consumers paid out of pocket in 2017, which experts estimate ranges between $4,500 and $8,300. A March 2018 review published by the Journal of the American …
Denials, Denied: Moving From Denials Management to Denials Prevention
/ Posted in GeBBS Healthcare Solutions, Inc.Denials coming from all payers are steadily increasing. Similarly, denied claims based on “medical necessity” related to coding inadequacies are also on the rise. Coding continues to be an increasingly complex process – leaving room for more errors that will lead to more denials. While every healthcare organization dreads the financial impact of denials, few …
Avoiding Credit Balance Crisis – The Importance of Closely Monitoring for Overpayments
/ Posted in GeBBS Healthcare Solutions, Inc.It’s no secret that healthcare billing is complicated. If you’ve ever received a refund from a hospital or physician’s practice office months after a procedure or visit, that’s because credit balances are a frequent occurrence in the complex world of healthcare finance. While they’re all too common, credit balances need to be monitored closely to …
Patient Experience & The Revenue Cycle – They’re Much More Connected Than You Think
/ Posted in GeBBS Healthcare Solutions, Inc.In the hospital environment, patient satisfaction is no longer a “fluffy,” nice-to-have concept for a few customer service representatives to manage. It has transformed into the all-encompassing patient experience and involves all aspects of the revenue cycle. Many organizations now have a Chief Experience Officer (CXO) and large, strategic teams leading systemwide initiatives designed to …