Check payments and healthcare news

Root Cause Analysis Is the Foundation to Denied Claim Analysis

December 27, 2017 / 0 Comments

Of course, the best way to handle claim denials is to prevent them in the first place. That’s why this recent list of denial prevention strategies from Becker’s is something no denial manager should miss. We believe though that it has a problem. Boiling down denials to a list like this obscures the fact that…

Read More

These “Far-Out” Denials Can Cause Real Audit Problems

December 21, 2017 / 0 Comments

You might have heard of some of these “far-out” denials from an HME NewsPoll, but they really are worth a review… …a Medicare prescription denied because it was “written by a girl.” …an agency that had a beneficiary “listed as dead, then alive, then dead again.” …multiple providers receiving denials for wheelchairs intended for amputees…

Read More

ONC and Innovation

December 20, 2017 / 0 Comments

The 2017 ONC Annual Meeting, held November 30th to December 1st in Washington DC, was all about healthcare interoperability and health IT usability this year. The Office of the National Coordinator for Health Information Technology (ONC) is organizationally located within the Office of the Secretary for the U.S. Department of Health and Human Services (HHS), and leads the…

Read More

Find Out Where You Stand Today on This Controversial DME Prior Authorization Rule

December 14, 2017 / 0 Comments

Becker’s announcement on CMS’ DME prior authorization rule came a while back, but CMS’ stance on prior authorization is likely still causing denial issues for your facility today. The Backstory Just as 2016 was about to round the corner, CMS issued a rule requiring prior authorization before Medicare would reimburse DME that had been found…

Read More

Telemedicine’s Newest Threat. DME Denials?

December 6, 2017 / 0 Comments

A recent report from Grand View Research reveals a potentially hidden threat to telemedicine programs. We’re all aware that chronic disease is a growing problem around the world, but did you know that the diabetic foot ulcer treatment market alone is valued at over $3.15 billion?  Statistics like that mean the results of a report…

Read More

CPAP Denials Are A Bigger Deal Than You Thought.

November 28, 2017 / 0 Comments

Earlier this year, The Huffington Post reported on the largely negative impact Medicare regulations are having on CPAP users and providers. On the provider side specifically, CPAP denials have been known to top denials lists for HME and DME suppliers, meaning that understanding the layers of Medicare’s logic is the first step in understanding how…

Read More

Are You Analyzing Your DME/HME Claims Denials?

November 22, 2017 / 0 Comments

The CHANGE HEALTHCARE HEALTHY HOSPITAL REVENUE CYCLE INDEX estimates that out of the $3 trillion in claims that were submitted in 2016, 9 percent ($262 billion in charges) were initially denied. For your average health system, that adds up to as much as 3.3 percent of NPR, dinging them for an average of $4.9 million…

Read More

Newsflash: 90 Percent Jump in Uncollectable Denials in Just 6 Years

November 17, 2017 / 0 Comments

It looks like 2018 is going to be the year of denials and that’s exactly as foreboding as it sounds. Becker’s article based on the Advisory Board’s survey revealed that denials written-off as uncollectable, costs the average 350-bed hospital $3.5 million annually; a whopping 90 percent jump from just six years prior. Compounding this challenge…

Read More

Cloud-Hosted vs. On-Premises Healthcare Applications

August 3, 2017 / 0 Comments

Adoption is driving huge growth for cloud IT vendors. However, an article at HIT Infrastructure shows that, in spite of the many advantages of cloud-hosted Healthcare computing — increased flexibility as well as less expensive scale when more space is needed (among other strengths) — many healthcare organizations are still weighing their options. IT departments who…

Read More

2017 Industry Survey: The State of Healthcare Payment Electronification in U.S. Hospitals

July 27, 2017 / 0 Comments

What’s really happening in hospitals related to electronification of payments? Have other topics become a priority? Are there “hidden” problems in infrastructure which are adding excessive costs to the healthcare industry?  Along with Commonwealth Health Advisors, OrboGraph completed a market research initiative which surveyed over 100 US hospitals. The objective of the research was to…

Read More