How to Create a More Effective Patient Financial Experience to Improve Post-Pandemic Collections
Surprise billing. It’s a term we’re all familiar with, one describing a too-frequent occurrence where patients receive large bills for services they didn’t realize weren’t covered. The primary culprit is an unexpected hospitalization or ED admission where treatment is provided by an out-of-network (OON) provider—a situation patients have no control over. The patient’s insurer—considering they […]
Hundreds of payers with varying deadlines. How to stay on top of timely filing requirements and avoid denied claims.
Have you noticed your payers denying more claims lately? It’s not your imagination. According to the Advisory Board, payers are using more sophisticated technology to catch and flag claims for denial, including potential DRG downgrades and medical necessity issues. And many have begun adding their own criteria on top of those recommended by the CMS, […]
Denied Claims Means Denied Revenue – Part 2
FIVE OPPORTUNITIES TO REDUCE DENIALS AND MITIGATE THEIR IMPACT The Kaiser Family Foundation recently reviewed CMS data from 2017 and discovered that 18% of in-network claims were denied by issuers that year.[1] But that numbered varied from as little as 1% to as much as 40%. The research also found that less than one-half of […]
Denied Claims Means Denied Revenue – Part 1
IF YOUR DENIALS RATE SEEMS TO BE GETTING WORSE, YOU’RE NOT ALONE Many providers just accept denials as an unavoidable part of the revenue cycle. But the damage caused by that mindset goes directly to the bottom line. Denial-related write-offs increased more than 90% between 2011 and 2017, costing medium-sized hospitals approximately $3.5 million in […]
Ten Guidelines for Choosing a Billing and Collections Partner
The holidays can wreak havoc on a hospital’s bottom line. The annual increase in ED visits means an increase in post-holiday self-pay collections. When the hospital bill arrives at the same time the credit card bills hit, collecting becomes that much more difficult. Many hospitals also see a rise in ED visits by those vacationing […]
The Not-So-Obvious Impact Of Holiday Visits To The ED
According to Consumer Reports, the incidents of heart attacks falls, and fires around the home increase during the holidays. [1] And this means a spike in visits to the E.D. around Thanksgiving, Christmas, and New Year’s Eve. Just as E.D. visits increase, so do requests for time off, which makes staffing up for the holiday […]
5 Things to Consider When Choosing an International Claims Partner
According to the American Hospital Association, hospitals write off more than $38 billion in uncompensated care-based costs each year.[1]Whether from uninsured, under-insured, increasing self-pay, or reduced reimbursements—the hit to the bottom line is significant. Many turn to cost-cutting measures as a way to mitigate the damage. But a 2017 Advisory Board report found that the […]
Reducing the Complexity of International Claims
Nearly 80 million foreigners visited the US in 2018[1]. Around 10 million have long-term visas that allow them to stay anywhere from a few months to a few years.[2]Visiting an ER during a visit—short or long-term—is likely the last thing anyone wants, but it happens more often than you may expect. And when it does, […]