There are many different factors that can lead to rising audits and denials within any healthcare organization. Even when all the boxes seem to be checked, denials continue to rise.
As the Patient-Driven Groupings Model (PDGM) is approaching, organizations are currently focusing on how it will impact revenue cycle functions. To prepare financially prior to PDGM’s implementation date of January 1, 2020, home health organizations can focus on cash collections to be prepared for any loss or delay in cash flow due to the significant changes under the new model and identify risks that could cause potential delays across the revenue cycle.
Home health organizations depend on their staff and tracking systems for a quick and efficient order management process. Order management is a key component within the revenue cycle process, as the collection of physician documentation is required to initiate any billing process. A bill cannot be generated without first obtaining all necessary orders.
Skilled Nursing Billing Outsource Solution Increases Provider’s Cash Collection by 17%, Reduces Billing Errors by 80%
As the saying goes: “Cash is King”. Maintaining a steady cash flow is one of the pervasive issues that affects many health care providers, especially in a time when economies of scale are rapidly transforming the landscape of health care.
The Office of Inspector General (OIG) is reviewing payments under the Post Acute Transfer (PACT) policy again. Why? The OIG wants to ensure claims are properly paid by the MACs with the controls they have put into place through claim editing. The OIGs follow-up will determine whether
The Patient-Driven Groupings Model (PDGM), is the most significant change to the home health payment reform in the past 20 years. PDGM completely alters the methodology for calculating payments, and an example of this is the removal of therapy utilization as a component and the payment periods have been reduced from 60 to 30-days...
Cash flow maintenance is paramount to sustaining any health care provider, especially through this era of rapid policy change and regulation. Organizations attempting to go through transitional phases such as process realignment and systems implementation are especially susceptible to reduced cash flow, both during and following these transitions...
Implementing a comprehensive internal audit program will position a facility to actively respond to the ever-changing healthcare regulatory environment. Achieving effective and compliant healthcare functions cannot occur without well-defined and ongoing compliance auditing.
A well thought out payer matrix can become the central knowledge base of any revenue cycle department. It’s a resource that will serve many operational purposes and ensure that organizational knowledge is well distributed without being lost.