eSolutions would like to wish everyone a happy holiday season the best way we know how, by helping you with your Medicare billing!
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.
A practice management (PM) system is the glue that binds a healthcare provider practice. It’s the primary tool office staff count on for effective communication and streamlined coordination between patients, providers and systems. A PM system tracks many moving parts of your business, and your patients are counting on your office to run smoothly.
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 “silver tsunami” of baby boomers aging into Medicare continues, so does enrollment in Medicare Advantage (MA) plans. A staggering 10,000 people are eligible to enroll in Medicare each day. From 2008 to 2017, MA plan enrollment grew from 9.7 million to 19.6 million. This growth represents 34 percent of all Medicare beneficiaries.
The financial health of your skilled nursing facility (SNF) depends on claims that are sent on time and accurately. If you’re in the SNF business, you understand the complex process of submitting claims and getting properly paid. The success of reimbursement depends on countless tasks going off without a hitch and in the right order. And if even one task goes wrong, it leads to big problems.
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.
If you're a healthcare provider outsourcing your medical billing, you put enormous trust into a third party biller to manage the most important aspect of your business - your revenue. Check out our latest infographic that outlines six key areas to watch closely if you outsource your Medicare billing.