Healthcare RCM

    5 Radiology  Billing Errors That Lead to Revenue Drain!   Our healthcare system is still reeling under the economic and operational pressures that the Covid-19 pandemic had brought in its wake. For radiology practices, the economic stress of the pandemic has been particularly severe. Examination volumes have gone down, rules have changed and revenues have started to dwindle. A special report from the RSNA Covid-19 task force has revealed that the drop in examination volumes for some private radiology practices in the last year has been higher than 80 percent!  While the economy is slowly edging back to normal, the threats of a second and third wave loom large over the horizon spelling low profitability for radiology departments and imaging centers. In these challenging times, it is utterly crucial for radiology practices to re-focus on revenue cycle efficiency. This is definitely not the time to leave money on the table for any reason, especially for mistake...

    INTRODUCTION Is outsourcing helpful or not? Among most medical practices, it is the state of doubt and dilemma. Based on several important variables: company size, age, and state of finances, the solution ranges from one practice to another. The most critical procedures in your organization apart from medical practices are billing and revenue cycle management. More than outsourcing In-house billing has its advantages and has its drawbacks too. To balance the two, what are the Pros and Cons of in-house billing and outsourced medical billing? PROS Cost-Efficient Cost savings is the primary reason why outsourced medical billing is an asset. The fact that you no longer bear the cost of medical billing technology, applications, etc would improve your financial position. Practicing Visibility At any particular time, an efficient medical billing firm must be able to generate multiple comprehensive reports. Without demanding the micromanagement of the workers, this flexibility off...

  Imagine putting all your money in a bag with a hole! Most of us would wince at such indiscretion, wouldn’t we? But denials, the proverbial holes in the coffers of healthcare businesses are mostly left unmanaged. An average hospital faces a loss of around $5 million in denials every year. And surprisingly, nearly 65% of those denied claims are not resubmitted again! Why do hospitals and healthcare services choose to close their eyes to this gaping drain in their revenues? Well, studies and interviews reveal that most health organizations are deterred by the time, labor, and cost that denial management calls for! So the question that naturally follows is how hospitals can manage their denials without stretching their resources? The recourse we feel lies in a thorough and holistic approach that looks at denial management from every facet and works at it from the base to the top. We need to devise strategies that address the root causes and work at eliminating them. Here are some hel...

Any business, even if it’s a noble service like healthcare can come to naught if payments are not received on time. Mounting accounts receivables and erratic cash flows are problems that many healthcare services are grappling with today. But surprisingly, the solution to these can be quite simple – diligent A/R follow-ups! Industry statistics tell us that not following up on unpaid claims results in nearly a 25% loss in revenue. Then a clear corollary that we can infer from this fact is that  A/R follow-ups  can significantly ramp up your health practice’s revenues.  What Do A/R Follow-ups entail? A/R follow-ups is a systematic process that billing teams or medical billing companies follow to collect the outstanding payments. An A/R follow up process typically includes three main stages.  Evaluation Analysis and Segregation based on Priority Collection Why are A/R follow-ups important? And if the boost in revenue is not enough reason for healthcare companies to focus...

Challenges and the US Healthcare Industry go hand in hand. From constantly evolving payment systems, increasingly labyrinthine regulations to the terrifying Covid-19 Crisis that’s before us today, the challenges we need to counter are many and possibly, never-ending. To surmount these problems and be ever-ready to meet new ones, we must build strength and resilience from within. One way to do that is to focus on improving our  core operational efficiency .  “Operational Excellence remains a greater imperative than most companies and most executives acknowledge,”   says    Gene Tyndall, President Supply Chain Excellence Advisors. This is especially true of the US Healthcare Industry where administrative costs far exceed those of healthcare industries in other comparable countries.  The Centre for American Progress (CAP) estimates that the annual  Billing and Insurance related costs borne by providers and payers are a startling  $4...

Scheduling is one of the simplest and most basic steps in the healthcare revenue cycle. But it is not any less important. As the first context of contact with the patient, it strongly affects the entire experience that a patient has with your healthcare service. A 2017 study by the University of Utah reports that 39% of patients surveyed considered scheduling a timely doctor appointment as the most important expectation they have from a healthcare service. That is not quite surprising when you consider the results of another study. In this one, more than 30 % of the patients under the study with an urgent medical problem reported that they were not able to schedule appointments on time.  So as a  healthcare provider , the first constructive step towards enhancing the quality of care you provide and streamlining your revenue cycle is to improve your patient scheduling process. But how can you do that? Here are six ways that will surely make your scheduling process run a...

Crisis begets change. True to the saying, the Covid-19 crisis we face today has ushered in many changes in the US healthcare system. It has changed the way we see and it has definitely changed the way we do things. For instance, it has transformed the way we deliver healthcare. One of the positive changes that the pandemic has brought about is the acceleration of Telehealth’s foray into mainstream medicine. Telehealth is not by any means new to US healthcare. It was already touted as the fastest-growing medical care service by an AMA study conducted in 2019, pegging the growth rate at a striking rate of 53% with more than 76% of hospitals in the country offering the service. This year the pandemic is slowly yet forcefully pushing this number closer to 100. From big multispecialty hospitals to small single physician practices, every player in the healthcare business is now looking at telehealth as a viable way to continue serving the community with quality healthcare. But...