Hayes' Healthcare Blog

3 Benefits of a Data Driven Approach to Billing Integrity

Posted by Robert Freedman on September 6, 2017 at 9:00 AM

Six trends affecting the healthcare billing industry in 2017 have been identified by MedicalBillersandCoders.com. They include the transition from ICD-9 to ICD-10, implementation of CPT codes, evolution of EHR management, the rise of money managers, cognitive computing and onset of block chain technology.[1]

As the healthcare industry continues to evolve, more focus is being placed on revenue integrity. This means more intense scrutiny on every element of the revenue cycle from the front end through the mid-cycle to the back office. No aspect of the revenue cycle is receiving more attention than the billing function.

Organizations must deal with these trends while at the same time ensuring the quality of their billing function. Many rely on auditing to monitor their billing processes and make sure billing departments are being run effectively. However, the key to proper billing is identifying root cause issues and applying appropriate corrective action. Auditing is simply a tool to help accomplish that, not an end in itself.

To ensure billing integrity, organizations must develop a process that is supported by a system. Auditing is only one element of an oversight system that also includes analysis and corrective action. Taken together, this system supports a data-driven approach that can enhance billing integrity. The system should effectively translate patient encounters into proper coding to ensure full payment and maintain compliance – making sure you get to keep what you have collected.

The system ultimately needs to be driven by data, since data gives you analysis that provides insight necessary to implement improvement. Here are three key benefits of a data-driven approach to ensuring billing integrity.

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Topics: compliance risk, mdaudit, Revenue Cycle Health, revenue integrity

Leveraging Your Epic System in the 3 Revenue Cycle Streams

Posted by Clinical Transformation Team on July 19, 2017 at 9:00 AM

As organizations continue to struggle with reduced top and bottom lines, they are increasingly focused on maintaining revenue integrity. That means optimizing processes and workflows in each of the three major revenue cycle streams – upstream (patient engagement), midstream (revenue recognition) and backstream (billing and collection). Fortunately, if you are an Epic user, you have tools in each of the three streams to help improve your revenue integrity accuracy, efficiency and productivity.

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Topics: epic, Revenue Cycle Health

3 Secrets to Save on Healthcare IT Costs

Posted by Angela Hunsberger on October 28, 2015 at 9:00 AM

More than ever, technology is a mainstay in delivering healthcare. Demand for services and solutions are in full swing thanks to incentive program participation, the shift in outcome-based pay models, and practices affiliating with hospital networks. For many practices, fluctuating program guidelines combined with the rushed pace of technology adoption has resulted in an overconsumption of software products. Focusing on a moving target makes it difficult to spot areas that could be unnecessarily costing your organization a significant amount of money. The next few paragraphs will reveal how to identify opportunities to save on healthcare IT costs. The advice is free and the payoff is priceless.

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Topics: IT staff management, HIT, business management, Revenue Cycle Health, healthcare IT costs

4 Ways Front Desk Staff Impact Your Revenue Cycle

Posted by Angela Hunsberger on September 2, 2015 at 9:00 AM

Early in my career, I worked for two providers in a small privately-owned practice in the Midwest. For seven years I sat behind the front desk scheduling patients, checking them in, updating demographics, and filing insurance claims. My manager trained me to be thorough and accurate but yet I had no clue how truly significant my actions impacted our bottom line. Back then, the most important thing to remember was to obtain a good address so we could send a bill if needed. Boy, was I short-sighted.

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Topics: patient satisfaction, Revenue Cycle Health, system analysis

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