The Medicare claims process is not for the faint of heart and can be frustrating even for the most seasoned hospital biller. Billing Medicare is one of the most complicated yet critical tasks in hospital revenue cycle management. The process is distinctly different from billing commercial payers, with Medicare-specific requirements and systems.
Denials can hit your healthcare organization where it hurts. According to MGMA, the average denial rate of a physician practice ranges from five to 10 percent. The median 350-bed hospital saw average write-offs from denials rise to $7 million in 2017.
As the healthcare industry changes certain things become outdated, and medical facilities are not immune to these changes. Ongoing medical research constantly unearths new and innovative ways to treat people. This leaves facilities, notably specialized facilities, unneeded and abandoned. Unfortunately, many of these establishments have tragic pasts, and some are even rumored to be haunted. This Halloween we’re telling the stories of 5 abandoned institutions that are sure to make your hair stand on end.
As the hospice care landscape changes, so do the rules and regulations surrounding hospice billing and reimbursement. Hospice agencies are faced with regulation requirements that make submitting claims and reporting data more complex. For new hospices, deciding where to focus and assign resources might feel overwhelming. The hospice revenue cycle experts at eSolutions have developed this guide to help hospices make sense of Medicare billing so you can get paid quickly and accurately - and feel less stress.
Billing claims is difficult work. As the insurance industry continues to grow in complexity, it’s no wonder more providers are turning to clearinghouse services than ever before. But with so many choices available for processing claims, how can you make sure your clearinghouse partner is doing everything it can to improve the health of your billing process? This guide will assist you with evaluating your current service and highlight some of the key logistics of switching to a new clearinghouse.
As our population ages and more people are taking advantage of home care services, the home health industry will continue to expand. For new home health agencies, deciding where to focus and assign resources might feel overwhelming. Home health billing and claims management through Medicare is complex, which is why we've developed an easy-to-understand guide to help new agencies get started.
In a recent survey of hospital CEOs, the American College of Healthcare Executives reports that CEOs ranked financial challenges as the number one issue facing hospitals. Some of the top financial challenges these CEOs identified include Medicaid reimbursement, revenue cycle management, managed care and commercial insurance payments, and reducing operating costs.
It's clear hospitals should track specific financial key performance indicators (KPIs) to monitor and evaluate financial health and profitability. But at every turn, hospitals are expected to measure and deliver indicators – from quality to financial to clinical to operational. With so many required indicators to report, it may feel overwhelming for hospital leaders to know exactly which financial KPIs they should track. Our hospital revenue cycle experts at eSolutions have created a list of the top 5 financial metrics any hospital should closely watch.
Why is automation important in a claims clearinghouse? Automation adds intelligence and agility to your claims submission process and revenue cycle. This equals less stress for your team, cleaner claims and improved reimbursement.
Providers should use Electronic Data Interchange (EDI) as more than a simple pipeline to submit claims. Many organizations don’t tap into existing sophisticated EDI functionality that streamlines processes, finds missing revenue, improves cash flow and so much more. An advanced clearinghouse with automated features takes full advantage of EDI functionality.