Insights and discussion impacting revenue cycle management
Revenue Cycle Update Newsletter
This monthly newsletter provides thought leadership and practical advice to help our clients anticipate change and adjust processes in time to optimize performance.
Tip of the Month
HFS has many services that are listed on the practitioner fee schedule as “hand-priced.” When billed electronically without following the hand-priced guidelines these are sometimes mistaken as non-covered services. Refer to the practitioner handbook key for specific billing guidelines to ensure proper reimbursement. This is particularly relevant
for oncology services.
There’s Gold in the Zero Balance Review
Zero balance reviews, as they are known, offer the opportunity to find out how accurately are payers paying their bills. Often providers don’t know this and are surprised by the results. These reviews also find many claims that can be reopened to recoup lost revenue. Even if it is too late to claw back payments, the zero balance review opens up vast opportunities to improve processes to ensure higher future revenue.
After claims are closed, most hospitals and health systems, many with six figures’ worth of claims annually, will not review accounts that have been paid or adjusted off. Certainly, they will look at outright denials, especially if there is a pattern. But closed claims mostly have been the Dead Letter Offices of the healthcare system.
And yet, there may be gold in them. In fact, it is likely.Jesse Ford
Read our Co-authored Series on Revenue Cycle Management in Community/Safety Net Hospitals
Salud Revenue Partners collaborated with senior healthcare leaders on a series of four articles exploring revenue cycle challenges affecting community and safety net providers. The series was published by Becker’s Hospital Review, a major trade journal, and tells how many community providers, including safety net hospitals, haven’t adequately addressed fundamental challenges in the revenue cycle created by health payment reforms, vast changes in the insurance markets and the rise of healthcare consumerism.
Part 1: Are community hospitals ready for the new world of revenue cycle management?
Part 2: ICD-10 still offers myriad challenges: More turn to outsourced services to generate bills, revenue
Part 3: Meeting revenue cycle’s biggest challenge: The rise in patients’ share of the cost burden
Part 4: The revenue cycle outsourcing decision: finding a responsible partner that improves your finances without burning bridges
Jesse Ford, CEO, Salud Revenue Partners