Focus on eight areas in the revenue cycle. The key to improving your organization’s bottom line, and to preventing denials, is to focus on the management of the revenue cycle. Denial Management Requires a Comprehensive Approach Successful denial management is more than just following up on denials — it’s preventing them in the first place. ...
In Audit
Jun 8th, 2016
The Centers for Medicare & Medicaid Services (CMS) has made a number of changes to the Recovery Audit Program for 2016. One of those changes is the length of time a provider has to submit a Discussion Request to a recovery audit contractor (RAC) following an automated review. CMS is also establishing Additional Documentation Request ...
Before denials and resubmissions take a toll on your practice, have a game plan that gets you paid. Fighting with an insurance company to get claims paid can be difficult. Accounts receivable staff must be on top of their game because incoming payments are needed to pay the light bill, the doctor’s malpractice premium, our ...
In Billing
May 6th, 2015
Documentation supports reimbursement; therefore, you must be certain that the information is straightforward and accurate, and that it “flows” in chronological order. Be mindful that clinical documentation also service as legal documentation. Some of the most common deficiencies found in documentation are: Lack of patient signature, such as: ABN not signed Financial policy not signed Physician ord...
Dec 1st, 2012
By Jim Denny, MBA Every practice knows that cash flow is a key indicator of financial health, but other key metrics should be evaluated to see the true state of a practice. By regularly looking at the number of days in accounts receivable (A/R), A/R greater than 120 days, collection rate, and denial rate, for ...