The basic goal of population health management is to manage the health of a defined population optimally by providing the right intervention(s) to the right people at the right time. Well-designed population health tools when implemented thoroughly, benefits the patient, makes workflow easier for the provider and keeps costs low for health systems and payers.
It has been more than two years since Congress voted to enact the Medicare Access and CHIP Reauthorization Act of 2015 and subsequent deadlines for various aspects of the law were issued by the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS). And yet, surveys conducted earlier this year and a few conducted more recently indicate that a large number of healthcare professionals are not familiar with the Medicare Access and CHIP Reauthorization Act (MACRA).
Medicare Access and Chip Reauthorization Act (MACRA) will have a tremendous impact on the business and health care models in healthcare establishments throughout the country. MACRA is being implemented partially in most establishments voluntarily, to get a taste of what is yet to come and is expected to be fully implemented by the end of 2018.
Revenue cycle management throws up tons of data for tracking. However, not everything requires regular tracking and measuring. While it is important to look at all the data derived from the system periodically, it is very important to track and measure some key metrics regularly. Measuring the key metrics against the industry standard is a good way to determine where your processes require improvement.
Most patients and their families find it very difficult to understand their medical billing documents. Currently, there are no established standards for consumer medical billing documents and patients often receive multiple bills for the same episode of care, albeit varying in content and presentation, from different doctors, labs and hospitals. This makes it very difficult for the patient and their families to tally the bills;
Managing your healthcare revenue cycle is never easy. Revenue leaks can create havoc with your organizations financial viability. The root cause of revenue leaks are generally internal, with someone in the system or the system itself, not performing correctly or efficiently. According to Marc Lion, CEO of Lion & Company CPAs, the average medical practice has a 10 to 15 percent profit leak.
The medical billing coding system is about to get larger and tougher – with Centers for Disease Control and Prevention (CDC) and Centers for Medicare and Medicaid Services (CMS) adding 1900 diagnosis codes and 3651 hospital inpatient procedure codes to the ICD-10 coding system for fiscal year 2017. As it is, there are 68000 billing codes under ICD-10,
The biggest problem in revenue cycle management for healthcare facilities is unpaid bills for medical services provided. The acquisition of medical debt leads to a detrimental impact on medical care provided by the healthcare facility and negatively affects the healthcare industry in general. There is a dire need to redesign the medical billing system to ensure shrinkage of bad debts,
One of the biggest banes of healthcare revenue cycle management; denied claims are a major source of stress for healthcare facilities and have an adverse impact on the cash flow and net revenue for the facility. But before we start blaming the payers for these denials, let us look at the common reasons for claim denials.
Medical billing is an important part of your practice. In fact, it is one of the crucial aspects, which if ignored or not handled properly, can even lead to the practice eventually facing closure. Healthcare providers handle their medical billing either in-house or through outsourcing. However, the benefits of outsourcing your medical billing are far more than keeping them in-house.