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.
Payer denials, write-offs and claim rework can really hit a healthcare organization where it hurts the most – right in its bottom line.
Medical necessity is among the top-five reasons medical claims get denied, and those denials cost providers millions each year. In fact, medical necessity denials accounted for nearly 3 percent of all denials recorded in eSolutions’ TITAN performance insights tool, resulting in more than $8.9 billion in denied billed revenue since TITAN launched in 2011.
As CMS is expected to soon release a start date for Review Choice Demonstration for home health providers in Illinois, we're excited to announce the launch of our latest product. Our RCD product is an update to the Pre-Claim Review product from 2016 and is designed to assist home health agencies who choose pre-claim review to affirm their claims.
Processing times, denial rates, cash flow and alternative payment models – all just a few of the many business challenges healthcare organizations face. As providers identify areas in which to focus their efforts and maximize performance, a growing number are investing in business intelligence (BI) solutions featuring comparative analytics. These solutions help organizations identify areas of the business in which improvements will offer the greatest ROI.
For those Skilled Nursing Facilities (SNFs) new to billing Medicare, making heads or tails out of where to put your focus and resources might feel overwhelming.
Now that Villanova has been crowned the NCAA men's basketball champion and Notre Dame the NCAA women's basketball champion, it's time to name ours!
You guessed it! Your votes named Missing or Incorrect Claim Information the most prevalent and disruptive medical billing error. In order to help lessen the stress of some of your most common medical billing errors, we've listed your Final Four and how eSolutions can help your organization overcome these errors.
Medicare Secondary Payer (MSP) is the term used when Medicare is not the primary paying party. Heartache swirls around MSP claims for a variety of reasons, mainly because these claims are complex, need manual work and take the time from your busy billing team that it doesn't have.