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Medical Lockbox

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

December 21, 2017

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

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

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

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

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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Are You Analyzing Your DME/HME Claims Denials?

November 22, 2017

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…

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

November 17, 2017

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…

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Cloud-Hosted vs. On-Premises Healthcare Applications

August 3, 2017

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…

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

July 27, 2017

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…

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Integrating Care Standardization with Healthcare Revenue Cycle Excellence

June 22, 2017

RevCycleIntelligence.com reported that St. Luke’s Health System, one of 15 top health systems in 2017, was named as a top health system by Truven Health Analytics and IBM Watson Health based on care standardization! And how does this relate to revenue cycle?  “When you standardize your processes and you perform consistently, we have seen fewer of…

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