Patient Collection Rates Are Plummeting as Out-of-Pocket Costs Rise – We Weren’t Surprised!

Posted in Affordable Care Act, Healthcare Revenue Billing, Insurance Billing Solutions, Medical Billing BPO, Offshore Medical Billing, Outsourced Medical Billing, Self-Pay Collections

Hospitals reported that patient collection rates dropped by 17.6 percent once patients owed more than $1,200 in out-of-pocket costs, a Crowe Horwath study recently confirmed. Hospitals collect significantly less from patients with higher out-of-pocket costs. The study revealed that collection rates for patient accounts with balances greater than $5,000 were four times lower than collection …

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AHA President and CEO Asks President-Elect Trump For “Steady as She Goes” Effort on Healthcare

Posted in Best Practices, Healthcare Revenue Billing, Insurance Billing Solutions, Medical Billing BPO, RCM Solutions, Revenue Cycle Management (RCM), Revenue Cycle Solutions

By Nitin Thakor, GeBBS President & CEO AHA President and CEO Rick Pollack recently sent a congratulatory letter to President-elect Donald Trump and asking him to go slowly on changes to our healthcare delivery system, particularly when it comes to the Affordable Care Act (ACA). This is good advice since healthcare represents a significant portion …

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Beware of Secondary Injury to Your Wallet after an ER Visit

Posted in Healthcare Revenue Billing, Insurance Billing Solutions, Medical Billing BPO, RCM Solutions, Revenue Cycle Management (RCM), Revenue Cycle Solutions

A recent article in US News and World Reportexplained a little known fact of which most patients are completely unaware. A trip to the emergency room could cause a secondary injury to a patient’s wallet. Even if a patient goes to a hospital included in his or her health insurance network, if the emergency room …

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With the Start of ICD-10, It’s Now About Reducing the Denial Rate

Posted in Accounts Receivable (A/R), Best Practices, ICD-10, Insurance Billing Solutions

The world did not come to an end on October 1, 2015. With the start of ICD-10, healthcare professionals anticipated an overall reduction in productivity of their billing staff. In a pre-October 1 survey, 94% of respondents indicated that they expected increased denials, but only 30% had done any work toward solving the problem. If …

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Outsourcing Chronic Care Management Is a Win-Win for All!

Posted in Best Practices, Healthcare Revenue Billing, Insurance Billing Solutions

The Centers for Medicare & Medicaid Services (CMS) has begun paying providers for delivering non-face-to-face care to their Medicare patients with two or more chronic conditions. This is a win-win for everyone involved in the process. Patients will experience improved outcomes and physicians have the opportunity to increase their revenue streams. CMS created the new …

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New CMS Initiative Can Generate Revenue for Physicians

Posted in Best Practices, Healthcare Revenue Billing, Insurance Billing Solutions

The 2015 Medicare Physician Fee Schedule (PFS) will pay for non-face-to-face services for CPT Code 99490 — Chronic Care Management (CCM), reimbursing practices on an average of $42 per patient, per month. Of all the governmental mandates that have come along — this is a good one. It incentivizes physicians to extend their care management …

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Bypassing the Insurance Companies

Posted in Business Process Outsourcing (BPO), Insurance Billing Solutions

In an article entitled: “Boeing negotiates directly with more health systems” in this morning’s Modern Healthcare e-newsletter, it was reported that airplane manufacturer Boeing Co. will soon offer more employees the option of health benefits negotiated directly with local health systems. The employer, being skilled in the art of negotiations, is bypassing the big insurance …

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Top 10 Reasons Why You Should Outsource Your Revenue Cycle Activities

Posted in Affordable Care Act, Business Process Outsourcing (BPO), Insurance Billing Solutions, Medical Billing BPO, Medical Coding, Medical Coding BPO, Offshore Medical Billing, Offshore Medical Coding, Offshore Revenue Cycle Management, Remote Medical Coding, Revenue Cycle Management (RCM)

In today’s healthcare environment of shrinking reimbursements, due to governmental mandates and Medicare policy changes, the importance of maintaining a healthy revenue cycle is second only to providing the best patient care possible. Without an adequate margin there can be no medical mission. One way to ensure your revenue cycle remains as healthy as possible …

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ERAs Are a Win-Win over Paper EOBs

Posted in Accounts Receivable (A/R), Electronic Remittance Advices (ERAs), Explanations Of Benefits (EOBs), Insurance Billing Solutions, Revenue Cycle Management (RCM)

The introduction several years ago of the ERA (Electronic Remittance Advice) created a quantum leap in the healthcare billing arena by providing an improvement to the traditional, paper-based EOBs. Astonishingly, many providers have not taken advantage of this revolutionary change. It has been estimated that even today only 46 percent of the claims are processed …

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Patient Access Management: The New Vanguard in Healthcare

Posted in Insurance Billing Solutions, Patient Access Management, Revenue Cycle Management (RCM)

With all of the changes in healthcare reimbursement policies and the influx of high-deductible patients, healthcare providers need to shift their patient access management strategies to meet these new challenges. No longer can the registration process be looked upon as a simplistic completing of forms and getting the patient into a bed. Today’s patient access professional must be …

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