The Single Overarching Strategy That Will Help Improve Your Revenue Cycle

Posted in GeBBS Healthcare Solutions, Inc.

In the world of revenue cycle, there are dozens of sound strategies that can help busy hospitals and healthcare organizations drive greater efficiency – but at the end of the day, there’s only one method that truly works. Sounds easy, right?  Unfortunately, when you’re considering the complexities of the revenue cycle – nothing is as …

Continue Reading »

Natural Language Processing in Risk Adjustment Coding – It’s Not Just for Over-Reads

Posted in GeBBS Healthcare Solutions, Inc.

Risk Adjustment programs are here to stay as we move into a value-based world. With reimbursement for health plans and providers tied to these programs, ensuring they are lean, efficient, and providing ROI is a top priority. With that said, Risk Adjustment coding is no easy process with all the unstructured content found in electronic …

Continue Reading »

Payers Under Fire – Meeting FHIR Deadlines

Posted in GeBBS Healthcare Solutions, Inc.

As if 2020 wasn’t overwhelming enough for payers who are battling a global pandemic while navigating all the many changes it brings to policies and reimbursement – there’s also a mad dash underway to meet the deadline for Fast Healthcare Interoperability Resources (FHIR) exchange format standards which go into effect on July 1, 2021. This …

Continue Reading »

Is Technology the Remedy for HEDIS Headaches?

Posted in GeBBS Healthcare Solutions, Inc.

Payers and healthcare providers alike are in the constant pursuit of the triple aim in healthcare – including better quality, greater value, and improved patient satisfaction – as the shift to value-based care continues. For every health plan on the market, it’s critical to review and evaluate quality performance on a regular basis to ensure …

Continue Reading »

The Six Most Important Changes Coming to Medicare Advantage Plans in 2021

Posted in GeBBS Healthcare Solutions, Inc.

Enrollment in Medicare Advantage (MA) Plans continues to climb each year. In fact, Medicare Advantage enrollment has doubled over the last decade. As the program takes on its increasing share of Medicare beneficiaries, staying abreast of changes and developments to the program remains more important than ever. Next year’s changes to Medicare Advantage are both …

Continue Reading »

Price Transparency Pushes Forward in 2021

Posted in GeBBS Healthcare Solutions, Inc.

While consumers continue to demand greater value in healthcare, they have very little way of knowing if they’re getting it. That’s because healthcare (payers and providers) – full of its complexities, technical coding, billing practices, and claims adjudication – is one of the least transparent industries out there when it comes to pricing. Whether patients …

Continue Reading »

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 …

Continue Reading »

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 …

Continue Reading »

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 …

Continue Reading »

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 …

Continue Reading »