How much missed revenue due to denied claims?


An article in Healthcare IT News stated that 10% to 20% of claims that are denied can contribute to approximately 90% of missed revenue opportunities. However, a company experienced with RCM is able to maintain quality procedures and measures that keep pace with today’s ever-changing business needs and reimbursement models.

 

According to the Northern California Spring Conference, California health insurers rejected approximately 1 in every 5 medical claims, approximating $45.7 million in missed revenue between 2002 and 2009 alone (and that doesn’t include claims denied by Blue Shield of California).

 

Even more alarming are their statistics that a managed care hospital with a net revenue of $50 million may have – at any given time – $5 to $10 million in an open state of denial. Read more

4 Things every urgent care should know about health IT security


There’s no denying that the digital revolution has spawned an age of convenience, but with that convenience comes a growing concern for the security of consumer information.

This rings especially true for healthcare organizations that are responsible for mountains of patient information.

A stolen credit card can be canceled, but a medical record contains significantly more rich data and information about a person. These records contain family information, financial information, and of course, a medical history. “A person’s health information is worth 15 to 20 times more than financial information,” said Robert Wah, MD, President-elect of the American Medical Association and Chief Medical Officer for CSC, a health IT Company in Falls Church, VA.

Lisa Gallagher, Head of Privacy and Security at HIMSS agrees. “It’s easier for identity theft to take place from a medical record that’s not secure than it is from a financial record because they tend to be locked down a little better. Hackers and other perpetrators have moved to trying to get it from the medical record.”

All healthcare organizations, including urgent care centers, must educate themselves about health IT security so they can better protect their patients.

With this in mind, here are 4 things you should know about health IT security. Read more

 

Common Revenue Cycle Management Pitfalls to Avoid


When asked what the key to success is, most business owners will tell you the ability to stay competitive in the marketplace. Staying competitive is particularly important in the health care field where the financial success of a physician practice is fundamentally based on provider productivity and revenue cycle management. A practice that’s unable to reduce revenue leaks and increase their bottom line will have a hard time staying afloat.

When it comes to minimizing costs and managing revenue, medical practices of all sizes make the same mistakes. Here are 7 common RCM pitfalls to avoid at all costs.

Not Collecting at Point of Service

Not everyone is comfortable collecting from patients at point of service (POS), but avoiding this sometimes-difficult task can put your practice’s revenue at risk. You know firsthand that copays and reimbursements are a major part of how you and your staff get paid.

Should a payment not occur at POS, a lot of time and money is spent following up and chasing after patients. There are the endless phone calls and emails and paper invoices, and all of those “minor” expenses add up, not to mention the expense of having to hire a collections agency. Multiply these expenses by “X” number of patients and your revenue soon develops a slow and steady leak.

The moral of this RCM scenario is, it’s much harder to get patients to pay once they’ve been treated and are out the door, so make sure your staff has been trained on these procedures and can clearly communicate your collection policies. Read more 

MIPS Delay on the Cards


MIPS Delay on the Cards

MIPS (Merit-Based Incentive Payment System) delay & shorter reporting periods are the options CMS is willing to explore.

  • On July 13, at the congressional hearing on the Medicare Access and Chip authorization act, CMS Acting Administrator Andy Slavitt did not rule out the possibility of a MIPS delay.
  • Originally, MIPS is scheduled to start from January 2017 with payment adjustments beginning in 2019.
  • Since the release of the proposed rule, various physician groups have called for greater flexibilities, many of Which center around pushing the start date forward by at least six months.
  • With the final rule scheduled to release on November 1, leaving physicians with only two months to prepare CMS is Open to give physicians more time, said Slavitt. Read more

5 EHR Infographics that every provider must read


EHRs are an important element of the healthcare market. It is vital to realize the importance of EHRs and the direction the entire industry is headed in. With the help of info-graphics it is easier to show marketing trends, the following article will show you some of the best info-graphics relating to healthcare, ranging from subjects like; when to get a new EHR? What share do different vendors in the market hold? Does technology really improve the way a practice is run? Find out with below amongst many other important subjects.

1) Electronic Health Records Infographic

How do electronic health records (EHRs) connect you and your doctor? In the past, medical data was only stored on paper, making it difficult for your health care providers to share your information. Read more

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2) The 20 Most Popular EHR Software Solutions

As the deadline for implementation in the U.S. draws near, talk of electronic medical records (EMR) and electronic health records (EHR) software is a hot topic at the doctor’s office lately. These systems assist medical practitioners in the creation, storage, and organization of electronic medical records, including patient charts, electronic prescriptions, lab orders, and evaluations (just to name a few common features).  Read more

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3) Why are EHR users replacing EHR SOFTWARE?

 This infographic created for Honeywell depicts the top reasons why hospitals and medical practices are replacing their EHR software. See more

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4) 11 indicators that you need a new EHR

Often so deeply immersed in looking for ways to make their practice more efficient, physicians sometimes fail to see the most obvious hurdle preventing this very process from occurring; their EHR. If your Electronic Health Record (EHR) solution is not up to the mark, you might be losing out on precious profits, and incurring costs that you can easily overcome. Read more

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5) The Convergence of Big Data and EHR Infographic

“In the next 10 years, data science and software will do more for medicine than all of the biological sciences together,” said venture capitalist Vinod Khosla. Data science holds great promise for patient health, but patient data is only actionable in so far as it is digital. Read more

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