The Accounts Receivable numbers on most hospital balance sheets are inflated. To give your organization’s finance executives accurate revenue expectations, you must ensure that your receivable is as accurate as possible. Here are three areas where revenue cycle professionals can upgrade their procedures to maximize ...

Near the end of 2020, New Jersey Governor Phil Murphy signed Senate Bill 2380 into law, establishing that essential workers’ contraction of COVID-19 during the Public Health Emergency is considered work-related and fully compensable for the purposes of workers’ compensation. This law applies to any individuals who ...

In an effort to improve the patient experience, the healthcare industry is implementing new regulations and expectations regarding price transparency. As part of the new requirements, the Centers for Medicare and Medicaid Services’ (CMS) Price Transparency Final Rule will require hospitals operating in the U.S. to ...

Thanks to the recent Georgia Supreme Court ruling in Bowden v. The Medical Center (TMC), Georgia hospitals are free from the fear that filing a hospital lien at their chargemaster rates will result in a claim against them for fraud and negligent misrepresentation by a class or an individual uninsured patient. The ...

When dealing with motor vehicle accident (MVA) claims, the collection rate on third-party liability can be substantially higher than any other payment source—particularly involving patients who have no form of health insurance. Whether managed in-house or outsourced, third-party liability (TPL) programs often generate ...

Since the global outbreak of the novel coronavirus, many health systems have seen a decline in normal patient services, leaving gaps in revenue. In light of the national public health emergency, Congress has passed legislation designed to support both citizens and hospitals during the pandemic—but without a thorough ...

In a recently released Care Decision Insights, Humana announced that 145 formerly inpatient-only procedures are now approved at the outpatient level of care. According to Humana, the Centers for Medicare and Medicaid Services (CMS) says that its current inpatient-only list applies to traditional Medicare–but not ...

Patient access teams are the face of your facility. These staff members must ask the right questions, gather accurate information, and establish trust with patients from all walks of life. If hospital staff cannot provide answers or proper assistance, patients become frustrated and confused. The key is informed, ...

Even before the outbreak of the novel coronavirus, workers’ compensation claims posed significant revenue cycle management challenges for healthcare facilities. If a work-related illness or injury is overlooked initially—whether because the PAS misses it or the patient does not sufficiently disclose information—the ...

Some of the top challenges affecting health systems’ reimbursement involve physician credentialing and provider enrollment. Enrollment with various payors in multiple states can be a tedious process—and few hospitals are staffed sufficiently to onboard, credential, and enroll new providers. Facilities must also ensure ...