Hayes' Healthcare Blog

3 Steps: Drive Your Compliance Checkup Using the OIG Work Plan

Posted by Robert Freedman on February 25, 2015 at 9:00 AM

Nearly five billion dollars.

According to a report to Congress, that’s the amount returned to Uncle Sam in FY2014 as a result of healthcare oversight and investigations conducted by the Office of Inspector General (OIG). Avoiding this type of negative impact to cash flow and the bottom line is a matter of revenue integrity and is a high priority to most healthcare organizations.

The OIG Work Plan details areas of emphasis for their yearly compliance audit activities. Providers are encouraged to use the plan to prepare for potential audits. Using the Work Plan as a guide to review specific risk areas that impact your organization is the best way to create an effective compliance audit program and avoid paybacks.

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4 Ways to Improve Your End User System Testing

Posted by Paul Fox on February 18, 2015 at 9:00 AM

It seems that every install that I have been a part of for the past 25 years goes by the policy that the best way to test a new system is to have the same individuals on the build team to also be the testers. On its own merits, it may sound logical, but in practicality, it can be a regrettable business decision. But the question remains, is this the most effective and efficient process?

The subtle differences that I have learned along the way that fall between “efficient" and "effective" comes into play with system testing of any kind.

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Topics: training end users, system testing

Building a Better Billing Office: What You Need to Know

Posted by Clara Hocker on February 11, 2015 at 9:00 AM

When you think about combining your physician billing (PB) and hospital billing (HB) into one operation, there are many things to consider. This type of arrangement can either be called a central billing office or a single business office*; either way the result is an office where patients can call to discuss both hospital and professional billing services. Whatever label used, it’s unrealistic to to simply sit hospital and physician billers together and expect them to speak the same language, or put hospital and clinic customer service reps together, plug the phones in and be ready to go. So how do you combine your billing resources to ensure efficiency and flow?

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Topics: billing, centralized business operations, single billing office, Billing office

The Art of Paying It Forward: Credit Balances

Posted by Steven Botana on February 4, 2015 at 9:00 AM

While most organizations keep an eye on the bottom line by working their outstanding accounts receivable (A/R), one of the areas that can often be overlooked is working accounts that are in a credit balance state.

As revenue cycle professionals, our primary goal is to keep our A/R days down while collecting revenue in a timely and efficient manner. But, isn’t it equally important to provide that same measure of quality in refunding that money when an overpayment has been received and posted?

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Topics: claims process improvement

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