Billing and Collections
Does your organization have a planned response to virtual card claims payments by patients, and do you know your rights under the Affordable Care Act to a less expensive form of claims payment? It is important for providers to understand their rights under HIPAA and the ACA and make an educated decision.
Hospitals' struggle for financial sustainability continues and may be getting worse, as CFOs say information technology investments draw more resources than expected and threaten to crowd out other priorities.
It's the rare hospital that has never experienced delays in receiving reimbursement as a result of clinical documentation coding snafus. But hospitals that don't make a serious stab at clinical documentation improvement (CDI) will be poised to take an even harder hit come October 2015, the start date for ICD-10 implementation.
While some health systems are reluctant to publish prices without reforms of insurance practices and proper context for patients, some are trying to embrace transparency as a new model. Washington State's Everett Clinic is one of those pioneers.
It's never been more difficult for healthcare providers to collect payment for services provided. These recommendations will help you get the most from your efforts and avoid costly mistakes.
Though over 30 states have passed or proposed legislation to increase healthcare price transparency, and released median prices for specific services, many supporters of price transparency have pushed for more detailed data.
Commercial insurers inaccurately process about 20 percent of claims filed by medical practices. It's an industry standard that has weathered the test of time -- though not in a good way.
Significant inpatient pricing variation between hospitals in the state of Washington is "putting some consumers at financial risk," according to a recent study by the Washington Health Alliance. But the state's hospitals are questioning the report's conclusions, claiming that price variation should not be surprising.
Like many other industries, healthcare is looking to leverage information technology to transform financial payments and automate the posting of accounts payable and accounts receivable processing systems. But which method to choose?
Healthcare providers are realizing they must create and sustain a more effective revenue cycle to ensure long-term viability. To remain competitive, providers must closely evaluate the current state of their revenue cycle and implement improvement opportunities.