4 Cutting-Edge Ways to Prevent Patient Falls

In addition to a higher propensity for having chronic conditions, older adults are also frequently at a high risk for falling. Though falls can be prevented to an extent with lifestyle adjustments, clinical-community partnerships, and evidence-based programs, they are still one of the leading causes of fatal injury and are associated with high morbidity. As […]

Pulse Check: Ensuring ABN Compliance

As you well know, Advance Beneficiary Notices of Noncoverage (ABNs) are necessary whenever your organization determines that non-emergency Medicare services may not meet medical necessity. This allows the patient to determine if they want to receive the services and it alerts them to how much they may owe if the services are not found to […]

The First Use of an Automated Pass-Through Reprocessor

Date: August 14, 2018
Category: Supply Chain

Millions of medical procedures each year are performed using reprocessed endoscopes, flexible tubes with lights and cameras that allow physicians to see inside the patient’s body and diagnose and treat medical disorders. Though the reported incidence of hospital-acquired infections associated with endoscopes is low—1 per every 1.8 million procedures, according to the CDC—HAIs are more […]

Pulse Check: Ensuring System Logic and Process Flows are Working Together

Recently, the team was tasked with testing the logic of a billing system to ensure that it was catching all the NCCI edits needed on claims. In order to do this, the current process of NCCI edits needed to be assessed. Through this process, the team was able to flag different gaps within the system […]

Reimbursement And Regulations: E/M Codes, Anthem ED, Medicare Compliance

In keeping with its crusade to decrease the amount of paperwork physicians are saddled with, the CMS is proposing a sweeping change to how medical evaluation and management (E/M) codes will be reimbursed. This is potentially very large news, depending on what services are provided at your organization. The current structure for E/M codes have […]

Helping Patients During the Transition to New Medicare Cards

By: Kelli Jenkins
Date: August 3, 2018
Category: Revenue Cycle

Since April 2017, CMS has been rolling out its new Medicare beneficiary cards in phases to a variety of states and territories of the U.S., and many are still awaiting their arrival. As some healthcare organizations begin to encounter patients with new cards and many more prepare to, leaders may be wondering what impact—if any—this […]

The Opioid Epidemic: A Historical Perspective and Key Considerations

For decades, public health and government officials, special interest groups, researchers, and cancer advocates have been at the forefront of the anti-tobacco movement, fighting Big Tobacco companies and striving to deter tobacco use through tax hikes and public smoking bans, as well as increasing the accessibility of alternatives such as quit lines, nicotine patches, and […]

Pulse Check: Improving Revenue Cycle Operations and Maintaining Patient Satisfaction – Common Pitfalls to Avoid (Part 2)

Last week I discussed two pitfalls we commonly see at hospitals that threaten patient satisfaction: confusing patient statements and delayed patient refunds. Continuing the focus on the patient financial experience, the list of pitfalls expands. Pitfall 3: Inconsistent point of service collections Time and again, HBI sees patient access staff fail to advise patients of […]

CMS’ 2019 Outpatient Prospective Payment System Proposal: What Providers Should Know

CMS on Wednesday released a proposal for the 2019 Outpatient Prospective Payment System and Ambulatory Surgical Centers Payment System that would expand controversial site-neutral payment policies and 340B drug cuts. Site-Neutral Payment Proposals The agency is proposing to reimburse clinic visits—which it describes as checkups—provided at off-campus facilities at the same rate as clinic visits […]