Billions of Dollars Flow into Private Medicaid Plans with NO Cost Oversight or Efficacy of Treatment Determined

November 7th, 2018 / Tyler Cowart / Posted in RCM Solutions, Revenue Cycle Solutions

Cost containment has become a leading factor in the delivery of healthcare. What are some of the issues that are contributing to these burgeoning costs? One of them is Medicaid. We spent over $576 billion on Medicaid programs in 2017, as reported by the Kaiser Family Foundation.

Improving Revenue Cycle Management with Point of Service Collections via Estimation and Eligibility Checking

September 25th, 2018 / Tyler Cowart / Posted in Gebbs Healthcare

A significant share of today’s hospital and doctor reimbursements now come from patients rather than commercial payers, yet many providers haven’t updated their collection practices. As charge amounts on medical bills continue to rise, healthcare providers are increasingly challenged to collect the high deductible amounts owed them. Patients are also more conscious of how much …

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Expert Coding Can Ensure You Are Maximizing Your Revenue Cycle

September 11th, 2018 / Tyler Cowart / Posted in Gebbs Healthcare

Declining reimbursements are one of the biggest challenges healthcare providers face today. Ask any physician or hospital and they will tell you about the daily struggle of getting paid for their services. However, many healthcare providers are leaving a significant amount of money on the table by under coding.

Pre-authorization as a Service Requires Both Technology and Human Components

August 21st, 2018 / Tyler Cowart / Posted in Gebbs Healthcare

Most claim denials are due to the lack of verifying benefit information prior to services being provided. Insurance verification process is crucial for all hospital encounters, whether inpatient, outpatient or ambulatory care. It will ensure that the hospital or physician receives payment for services rendered and will help determine the patient’s share of the charges …

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Transforming the Business of Healthcare

June 15th, 2018 / Tyler Cowart / Posted in Gebbs Healthcare

The overall theme of this year’s HFMA Annual Conference is “Transforming the Business of Healthcare,” and it is right on target. No other industry is experiencing more evolution and transformational change than healthcare. It seems that the only thing we can count on is change — this is even more true for the business side …

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The Importance of Eligibility Verification and Pre-authorization

May 31st, 2018 / Tyler Cowart / Posted in Gebbs Healthcare

In medical billing terminology, eligibility verification, pre-authorization, prior authorization and pre-certification are terms that may be used interchangeably to mean that for certain situations and procedures, providers have to contact insurers in advance and obtain a certification number in order to be reimbursed properly (or at all) for services. Insurance verification and insurance authorization services …

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The Age of Revenue Cycle Management Outsourcing Has Arrived

May 17th, 2018 / Tyler Cowart / Posted in Gebbs Healthcare

The RevCycle Intelligence e-newsletter reported recently that 80 percent of hospitals are vetting full revenue cycle management (RCM) outsourcing. The demand to outsource full RCM is up 86 percent from 2015 among hospitals and inpatient organizations. Approximately 80 percent of hospital leaders in a new Black Book survey of 709 C-suite executives, board members, and …

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Revenue Cycle Management Is More Than Just Managing Your Cash Flow

May 1st, 2018 / Tyler Cowart / Posted in Gebbs Healthcare

Many healthcare providers are under the impression they can assess their financial health by evaluating cash flow only. However, cash flow is just one factor in revenue cycle management (RCM). To maintain a healthy revenue stream, healthcare providers need to understand the other important metrics that should be calculated and reviewed when evaluating their revenue …

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Rising Costs in Healthcare Lead to Increased Demand for Outsourced Solutions

April 5th, 2018 / Tyler Cowart / Posted in Gebbs Healthcare

Healthcare IT News reported recently that nearly three-quarters (73 percent) of health systems with more than 300 beds — and 81 percent of providers with fewer than 300 beds — are shifting their focus to IT outsourcing for development and complex infrastructure services. Their data was based on Black Book Research that surveyed 1,030 hospital …

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Walmart Reportedly in Early-stage Talks to Buy Humana

April 2nd, 2018 / Tyler Cowart / Posted in Gebbs Healthcare

Here we go again! In my last blog I mentioned how companies like Amazon, Google, Apple, Uber, etc. will be driving innovations in healthcare delivery and costs over the next 10 years. Today, the Wall Street Journal (WSJ) reported that retail giant Walmart is in preliminary talks with health insurer Humana about developing a closer …

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