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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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A Revenue Cycle Turnaround Case Study

December 14, 2017

We recommend you buy a Starbucks coffee and set aside an hour to watch the “Coffee With Coker” presentation entitled “Revenue Cycle Turnaround: Rebuilding for an Advanced ROI – A Case Study,” which is archived here. Senior Vice President of Coker Group Jeff Gorke takes us through the components and challenges of building and maintaining…

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Faster Payments May Not Be Fast Enough…To Market

December 13, 2017

They are called the Faster Payments Task Force. They’ve chronicled 252 meetings and teleconferences, 19 surveys and votes, and 120,000 estimated hours of work, the chronological equivalent of 13.7 years. The output is two impressive strategic reports totaling 126 pages, part one released a year ago this month, part two in July. And in retrospect, that…

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RCM Needs To Accept Millennials

November 21, 2017

Becker’s ASC Review reports that Millennials, or individuals born roughly between 1980 and 2000, now number 73 million in the United States (according to the polling firm Gallup). They are well on pace to soon outnumber Generation X — their immediate predecessors — at all U.S. companies. For review, here’s a timeline (just one of many…

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Australia’s New Payments Platform: Watch Out for Fraud, Say Experts

November 20, 2017

The Land Down Under is introducing New Payments Platform (NPP), the modestly-named and soon-to-be-launched system that will enable almost instantaneous transactions between banks and bank accounts, any day of the week. With convenience comes a level of jeopardy. Finder.com.au insights manager Graham Cooke told The New Daily that the new platform could expose consumers to fraud risks. “While…

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7 Strategies to Prevent Claims Denials

November 16, 2017

We operate in an already complicated reimbursements environment, so anything we can do to minimize the constant threat of denials is going to help the entire revenue cycle. Becker’s Hospital Review produced a helpful webinar discussing strategies to prevent claims denials that can be accessed here. In an article summing up the presentation, Becker’s distills…

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Out of the Trenches in the Battle Over Bank Customer Data

November 14, 2017

Fintechs and banks have been at odds with one another over customer information since the first moment that someone somewhere decided “fintech” was an actual word. American Banker reports that the icy relationship may be thawing. Fintechs have been arguing that they need to access bank customer account data to provide a variety of services,…

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Fee-For-Service Healthcare Payments – Shrinking

November 9, 2017

An article on the HealthExec website describes a Health Care Payment Learning and Action Network (LAN) report recently released, showing that 43 percent of payments to health systems came from traditional fee-for-service (FFS) payment models in 2016. That’s down from 62 percent the year before. Meanwhile, alternative payment models’ (APMs) share increased from 23 percent to 29 percent. While…

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Selling a Latte For $5; Collecting Only 50¢ at Time of Purchase …

November 6, 2017

Sometimes it’s instructive to remind ourselves just how “different” the world of health care payments can be. Consider Dr. Andrew L. Pecora’s Starbucks metaphor in an article entitled The Quirky Way Physicians Are Paid: Imagine a hypothetical board meeting at Starbucks Corporation where a newly hired CEO tells the board how he intends to increase same-store…

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