2018 Conference Highlight: Payment Reconciliation Realities

June 5, 2018 / 0 Comments

One of many highlights from our 2018 Healthcare and Check Payment Technology Conference in Nashville, TN, was Wayne Koch’s presentation exploring The Future of Healthcare Payments. We’ve borrowed the great visual metaphor that Koch used in his presentation: Very often, the amount of reconciled and unreconciled payments that current systems recognize are merely the tip of…

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orbonians

Healthcare and Cybersecurity – A Reminder via Facebook to Remain Vigilant

March 26, 2018 / 0 Comments

It shouldn’t take news of a massive data breach on Facebook to remind people in all industries – – particularly healthcare – – that we must remain absolutely vigilant when it comes to security and privacy requirements. As Rosemary McKenna states in her blog at Lexology: Nary a week goes by without news of a data…

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Report: Big Revenue Cycle Investments for Services Ahead

February 2, 2018 / 0 Comments

A new report from Future Market Insights has predicted that the global market for healthcare revenue cycle management software will reach $ 43.3 billion by the end of 2022. The global healthcare revenue cycle management software market is projected to soar at a compound annual growth rate of 6.9 percent during the 2017-2022 forecast period. Healthcare IT News analyzes…

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Medical Records on Your Apple iPhone: Will It Help the Patient Experience?

January 26, 2018 / 0 Comments

Mainstream technology is beginning to create patient-doctor relationships that are unprecedented. CNBC reports that Apple is moving deeper into healthcare with a service that lets users easily view their medical records. Ultimately, “we’re hoping to enable richer conversations between doctor and patient,” said Sumbul Desai, Apple’s digital health lead who’s also a physician and medical researcher…

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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…

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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 had a beneficiary “listed as dead, then alive, then dead again.” …multiple providers receiving denials for wheelchairs intended for amputees and…

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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…

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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…

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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…

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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…

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