Category: Custom Services

Reimbursement & Regulations: E&M, Social Determinants of Health, Kickbacks

By: Andrew Minten JD
Date: December 7, 2018
Category: Custom Services
Filed under: 2019 MPFS, CMS, E/M, E&M, HHS, Inpatient Billing, Kickbacks, Medicaid, Medicare, OIG Work Plan, Reimbursement & Regulations, Social determinants of health

Return readers will be happy to hear that the CMS is delaying its changes to E&M payments. In the 2019 Medicare Physician Fee Schedule Final Rule, the CMS stated it will not be reducing E&M payments from five levels to two, but to three levels, and that it will not be doing it until 2021. […]

Pulse Check: Maximizing Medicaid Expansion Benefits

By: Andrew Minten JD
Date: December 5, 2018
Category: Custom Services
Filed under: Financial Counselors, Idaho, Medicaid, Medicaid Application, Medicaid Expansion, Nebraska, Pulse Check, uncompensated care, Utah, Virginia

Three more states voted in this previous election to expand Medicaid. Virginia will be going forward with Medicaid expansion on January 1, 2019. Though Medicaid reimburses you at a very low rate, they will pay more than most self-pay patients and the cost to collect is much lower. The payer mix shifting from uninsured to […]

Pulse Check: Teaching Staff the Big Picture

By: Samuel DePaz
Date: November 28, 2018
Category: Custom Services
Filed under: Claim Resolution, key performance indicator, KPI, POS, Pulse Check, revenue cycle, Revenue Cycle Management, training, Workshops

In the past few months, I have been hearing a lot about organizations wanting to train staff on how to effectively resolve claims, interact with patients, have financial discussions with patients, and give holistic revenue cycle training. While training and resources around these are very important, many organizations struggle to connect these training opportunities with […]

Pulse Check: HBI Takes PFS Onboarding to Higher Education Realm

By: Noelle Wysocki
Date: November 21, 2018
Category: Custom Services
Filed under: Cal State LA, Cedars, Cedars-Sinai, Certification, CSULA, curriculum, DRG, DRG Learning, HBI, Healthcare Certification, onboarding, Pulse Check, RC, RC Administration, revenue cycle, training, Workforce Development

HBI is proud to present a unique training opportunity for current and potential revenue cycle staff in the Los Angeles area. Offered through California State University Los Angeles and taught by real revenue cycle leaders at Cedars-Sinai, HBI created a semester-long curriculum that prepares students to work as a patient financial services representative in a […]

Pulse Check: Combat High Staff Turnover Through Culture Change

By: Elisabeth Callahan
Date: November 14, 2018
Category: Custom Services
Filed under: culture, employee engagement, employee satisfaction, Pulse Check, staff turnover

My team has been receiving many requests for ideas on how to reduce staff turnover. Our response?  High turnover in a department is likely the symptom of a much larger issue, employee disengagement. A cultural transformation is needed in order to engage your employees. When a department has high turnover, staff often have tunnel vision […]

Pulse Check: Acting Like a Team

By: Andrew Minten JD
Date: November 7, 2018
Category: Custom Services
Filed under: Pulse Check, Teamwork

Hospitals are large sprawling workspaces. Staff are spread out among various departments, throughout the building or campus. Ensuring that revenue cycle staff are educated about the entire revenue cycle is, and what each department is responsible for is important, but fostering an environment in which every revenue cycle employee knows they are on the same […]

Reimbursement & Regulations: Sepsis, Medicare Part C, MBIs

By: Andrew Minten JD
Date: November 2, 2018
Category: Custom Services
Filed under: Anthem, CMS, DSH, HHS, MBI, Medicare, Medicare ID Cards, Medicare IDs, Medicare Part C, Reimbursement & Regulations, Sepsis, Sepsis-3, United Healthcare

Starting January 1, United Healthcare will use sepsis-3 criteria for the medical necessity of claims. Experts believe this could lead to higher denials in the near future. This change is for all of United Healthcare’s plans. Sepsis-3 defines sepsis as “life-threatening organ dysfunction caused by dysregulated host response to infection [suspected or confirmed].” Two standards […]

Pulse Check: Bolstering POS by Engaging in Community Outreach

By: Samuel DePaz
Date: October 31, 2018
Category: Custom Services
Filed under: Collections, Point of Service Collections, POS, Pulse Check, reduce A/R, revenue cycle, Revenue Cycle Management

Recently, I have been hearing a lot about point-of-service collections being a top initiative within 2018 and heading into 2019 for providers. According to Healthcare Business Insights most recent benchmark, the national average of point-of-service collections as a percent of net patient revenue is 0.5%. This is down from 1.3% the prior month, giving organizations […]