denials management

Denials Management

[vc_row][vc_column][rev_slider_vc alias="denials-management"][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]What exactly is denials management? What are the benefits of tracking and managing your denials? Who should be tracking your denials rate? In today’s blog, we’re going to explore these questions. Denials Management Denials management is the process of reporting on received denials on a regular timetable, usually set by executive management. Be it weekly or monthly, depending on the size of your practice, tracking your denials types will help...

Donna White
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New Year Resolution for a Better Revenue Cycle

Your Practice’s New Year Resolution: A Better Revenue Cycle

[vc_row][vc_column][rev_slider_vc alias="better-rev-cycle"][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Happy 2018! As you wrap up year end activities, now is the time to put into place solutions that will improve your revenue cycle for the entire year. Check in It starts at the beginning. That’s a little redundant isn’t it? But it’s true. Your revenue cycle starts when your patient checks into the office for their appointment. It is critical that any new insurance information is collected and verified....

Donna White
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Benefit verification

Benefit Eligibility & Verification

[vc_row][vc_column][rev_slider_vc alias="benefits-eligibility"][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Depending on your practice, eligibility can mean many different things to many different specialties. However, the key to a strong revenue cycle and patient collections strategy begins with eligibility verification. Basic Eligibility What is basic eligibility? This is checking with the insurance company ahead of the patient’s appointment to make sure they still have an active policy. You may have personnel dedicated to that task 2-3 days ahead of your scheduled...

Donna White
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‘Tis the Season to Be Jolly

[vc_row][vc_column][rev_slider_vc alias="tis-the-season"][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]“It's the Most Wonderful Time of the Year," and “Tis the Season to be Jolly” are phrases we hear in movies, carols and conversations, but the holidays are also a time when stress levels, pressure, depression or conflict are at an all-time high. We can feel overwhelmed by the expectations and even become depressed during the holidays. We all know that a lack of time and money, credit card...

Donna White
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Denials: The Growing Concern

[vc_row][vc_column][rev_slider_vc alias="denials-growing-concern"][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Denials are a fact of life for every medical practice. From demographic errors to medical necessity, denials come in easy to fix solutions and time-consuming levels of appeal. A recent article from the Healthcare Finance News website (http://www.healthcarefinancenews.com/news/denials-still-major-risk-revenue-cycle-departments-despite-build-out) noted that hospitals in particular “wrote off as uncollectable 90% more denials than 6 years ago.” The news is not all negative though. The article notes that “Medicare and Medicare advantage...

Donna White
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MIPS: Are you ready?

[vc_row][vc_column][rev_slider_vc alias="mips123"][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Previous government incentive programs like Physician Quality Reporting System (PQRS) and Meaningful Use (MU) have officially been phased out as of 2017. In healthcare, we have a new alphabet soup to work with to receive Medicare incentive payments called the Merit-based Incentive Payment System, or MIPS. In this article we’ll try to de-mystify some of the more complex aspects of the system. This system combines the previous measurement programs under...

Donna White
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Practice Analytics

[vc_row][vc_column][rev_slider_vc alias="practice-analytics"][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]You have heard the term from every technical vendor your work with – they will provide you a dashboard that will review for you top issues in your systems, compare your practice to similar sized practices and show where you rank nationally among their customers. While this is helpful data, reporting and analytics can be used to determine so much more. Clinical Reporting You are entering in so much information every...

Donna White
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Working Common Denials (part 2)

[vc_row][vc_column][rev_slider_vc alias="working-common-denials-part-2"][/vc_column][/vc_row][vc_row][vc_column][vc_column_text] In today’s article, we are going to continue to review best practices for follow up on some of the most common denials, regardless of specialty. Missing Information There are several types of common Missing Information denials. First you may be missing Medical Records. In this case, the payor needs the chart or progress note to process the claim. Call the payor and see if the records can be faxed. Be...

Donna White
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Credentialing and CAQH Completion

[vc_row][vc_column][rev_slider_vc alias="credentialing-and-caqh-completion"][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]One of the most important pieces to opening a new practice, or moving from one practice to another, is your payor Credentialing. This is a time intensive process most providers or office managers do not have the bandwidth for. This is where outsourcing your credentialing can be critical. You typically want to allow a minimum of 90 days prior to your practice opening, or move, to begin your credentialing...

Donna White
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Working Common Denials (part 1)

[vc_row][vc_column][rev_slider_vc alias="common-denials"][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Depending on your practice, there may be several types of top denials. In today’s article, we are going to review best practices for follow up on some of the most common denials, regardless of specialty. Coverage Termed/Expired Per the EOB, the patient’s service denied as Coverage Termed or Expired at the time of the service. In your practice management system, check the Insurance Screen’s eligibility area to see what eligibility information...

Donna White
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