Free Revenue Cycle e-Newsletters

APCs Weekly Monitor CDI Strategies Coding Educator Compliance Monitor Healthcare Auditing Weekly HealthLeaders Media Corner Office HealthLeaders Media Finance JustCoding News: Inpatient Medicare Weekly Update Patient Access Weekly Advisor Patient Financial Services Weekly Advisor The RAC Report

Patient Financial Services Weekly Advisor

Looking to improve your facility's bottom line and more effectively manage your patient financial services department? Get this free weekly e-mail that provides tips, advice and real-world strategies.

2009 | 2008 | 2007 | 2006 | 2005 | 2004

Patient Financial Services Weekly Advisor

Issue 39, December 17, 2004

• Joint effort by HIM and the business office helps manage the revenue cycle

  Teaming with health information management (HIM) can help you measure and track your revenue cycle...

• Revenue cycle team successes

  A: The main goal of our A/R team, created a few years ago, was to reduce our A/R days from highs in...

Issue 38, December 10, 2004

• Three steps to avoid accepting partial payments from plans

  Some health plans stamp the words "payment in full" on reimbursement checks that are made out for...

• Steps to manage length of stay

  A: Before embarking on a focused LOS program, it's imperative that your team ensure that clinical...

Issue 37, December 3, 2004 - VIEW THE FULL ISSUE

• Six steps to manage charity care processes

  Making sure your charity care policies are in place and are being followed throughout the facility...

Issue 36, November 19, 2004

• Consider software for medical necessity determinations for lab services

  Advance beneficiary notices (ABN) are an intricate part of laboratory compliance, and using a...

Issue 35, November 12, 2004

• Tip: Length of stay has a direct impact on your bottom line

  Length of stay (LOS) affects both cost and revenue and often has enormous implications to the...

• Tennessee may cut state health program that aids poor, uninsured

  Due to financial difficulties, Tennessee Gov. Phil Bredesen said November 10 he plans to dissolve...

Issue 34, November 5, 2004

• Tip: Review managed care contracts to ensure prompt, accurate reimbursement

  Tracking and analyzing underpayments and denials to determine root causes and prevent recurrences...

• CMS increases outpatient payment rates for preventive services

  Medicare beneficiaries will have more access to preventive benefits, quicker access to new...

Issue 33, October 29, 2004

• Tip: A team-based approach to reduce denials

  To avoid a Band-Aid remedy to reducing denials, it's crucial to identify the reason behind them to...

Issue 32, October 22, 2004 - VIEW THE FULL ISSUE - VIEW THE FULL ISSUE

Issue 31, October 15, 2004

• CMS launches demo for high-cost beneficiaries

  In a move to find ways to reduce costs and improve quality of life for Medicare beneficiaries who...

• Letter to the editor: prescription drug plan is misleading

  The Medicare prescription drug plan that is being touted by the current administration is at best...

Issue 30, October 8, 2004

• Tip: Process improvements make staff invested, accountable

  Editor's note: Jennifer Bette, supervisor, admitting, St. Helena (CA) Hospital, shares her success...

• News: CMS to expand coverage for insulin infusion pumps

  In response to Medtronic MiniMed's request to remove the C-Peptide testing requirement for insulin...

Issue 29, October 1, 2004

• Tip: 10 contract tips for patient access

  Contract issues related to the patient access area are often prevalent, and they cause denials down...

• Q: What are the responsibilities of an A/R task force, and who should be involve

  A: Our A/R task force consists of the business office director, the patient registration...

Issue 28, September 24, 2004

• Tip: Audit for medical necessity to catch lost revenue

  Hospitals are most susceptible to losses in the area of medical necessity for outpatient tests and...

• Defining indigency

  A: CMS has stated that indigency determinations are left in the hands of each provider. They simply...

• News: GAO report says Medicare is not appropriately recovering MSP debt

  Medicare contractors in 2003 collected just 38 cents for every dollar the program spent to recover...

Issue 27, September 17, 2004

• Medicare discount drug card for nursing home residents

  Medicare offers three approved prescription drug cards to assist in covering out-of-pocket...

Issue 26, September 3, 2004

• Tip: Scrutinize credit balances to help ensure prompt Medicare repayment

  Even if Medicare or another insurer overlooks a credit balance, keeping improper or excess payments...

• Tip: Mastering HINNs

  A hospital-issued notice of noncoverage (HINN) helps hospitals correctly establish Medicare...

• EOBs

  A: According to our policy, we keep remittances for six years, based on the federal code.

• HHS announces Medicare premium, deductibles for 2005

  HHS announced September 3 the Medicare premium, deductible, and coinsurance amounts to be paid by...

Issue 25, August 27, 2004

• Tip: Four ways to dodge Medicare claim denials

  Ambulatory surgery center reimbursement claims are often refused or reduced.

• Bad debt and Medicare

  Section 308 of the Provider Reimbursement Manual (PRM) states that providers must be able to...

Issue 23, August 20, 2004

• Tip: Choosing revenue cycle performance metrics

  Performance metrics are developed to measure the results of organizational policies, practices, and...

• Benchmarking for billing staff

  A: There is no one source for all benchmarks, but the following can be helpful resources:

Issue 22, August 13, 2004

• Tip: Use reconciliation reports to improve charge capture

  Avoid denials before they happen by ensuring accurate billing, says Susan Reaves, director of...

• Auditing CPT codes

  A: A solid and effective claims-auditing process is essential to ensuring accurate reimbursement is...

Issue 21, August 6, 2004

• Internet billing option yields positive results

  Internet billing and payment options can seem daunting, but the results can be worth the effort...

• Staffing for outpatient ambulatory registration

  A: There really aren't any formal staffing ratios for outpatient registration. There are several...

Issue 20, July 30, 2004

• ABNs and observation

  A: Before an ABN can be given, there must always be a reason to expect Medicare will deny payment...

Issue 19, July 23, 2004

• ABNs and billing beneficiaries

  In most cases, you cannot bill Medicare beneficiaries for charges that Medicare denies without...

• Matching collectors with accounts

  A: We have our collectors matched to certain payer groups-usually two people assigned to a group...

• Ernst & Young to pay $1.5 million for bad billing advice

  Ernst & Young-one of the nation's largest accounting firms-agreed to pay the U.S. government $1.5...

Issue 18, July 16, 2004

• Tip: Improve your written appeals

  Most written appeals of inpatient medical necessity denials can be improved, says Simon Rosenstein...

• Ask the expert: Denial management task force

  A: Task forces are the way of the future for revenue cycle processes, and the group should be a...

• RI reports on state's hospital performance

  The Rhode Island Department of Health on July 8 released The Health of RI's Hospitals (2003), which...

Issue 17, July 9, 2004

• Tip: 5 principles of denial prevention

  All successful communication in the medical necessity certification process relies on five key...

• FTE staffing formulas

  A: It's hard to say what the best staffing ratio is, since every business office is different. The...

• Pfizer provides drug discounts to Medicare beneficiaries

  Pfizer announced July 7 it will offer a flat $15-per-prescription fee to qualified Medicare...

Issue 16, July 2, 2004

• Avoid confusion on billing statements

  Patients who visited Fletcher Allen Health Care in Burlington, VT, were having trouble...

• Medical savings accounts (MSA)

  A: Medical savings accounts-tax-deferred accounts that allow patients to save money for medical...

• CMS encourages use of HIPAA-compliant electronic claims

  As of July 1, electronic Medicare claims that do not meet HIPAA standards will be treated as paper...

Issue 15, June 25, 2004

• Tip: Smoothing wrinkles in preregistration

  Preregistration has a wide array of definitions, varying from simply having an account number to a...

• Newborn preregistration process

  A: We do not preregister newborns, but we do have a quick registration process that our delivery...

• Prominent hospitals targeted in charity care class-action suits

  Several more hospitals and healthcare systems have been named in federal class-action lawsuits that...

Issue 14, June 18, 2004

• Tip: Registration process makeover

  The University of Pennsylvania Health System, during a lengthy revenue-cycle improvement process...

• Measuring effectiveness of your collection agency

  A: Reporting results is one of the hottest topics in healthcare today. It is hard to determine what...

• Almost one-third of people under 65 are uninsured

  Nearly 82 million people-one third of the U.S. population younger than 65-lacked health insurance...

Issue 13, June 11, 2004

• Tip: ABN do's and don'ts

  Advance beneficiary notices (ABN) have long been a source of confusion and stress. Here are some...

• Three-day window rule

  A: One of the most prevalent and costly forms of fraud and abuse is billing Medicare Part B for an...

• Healthcare spending slowing down

  Healthcare spending per privately insured American increased only 7.4% in 2003, which translates...

Issue 12, June 4, 2004

• Tip: Encourage documentation at time of order

  If you need to appeal to Medicare to pay your outpatient/emergency department (ED) claim, you'll...

• Team meeting strategies

  A: We have the following regular meetings:

• New average sales price reimbursement method affects hospitals

  Average sales price (ASP) will be the new method CMS will use to reimburse physician practices for...

Issue 11, May 28, 2004

• Team effort streamlines ADR process

  Over the past three years, Becky Cornett, PhD, CHC, has been hard at work on a piece of the puzzle...

• Denial management strategies

  A: Jill A. Frye, RN, BSN, MSA, director of access management services at Rex Healthcare in Raleigh...

• ER docs see more uninsured patients

  More than 70% of 2,000 emergency room (ER) physicians surveyed said they treated more uninsured...

Issue 10, May 21, 2004

• Tip: Claims denial audits

  Monitoring and correcting claims denials has many benefits. Review your facility's claims denials...

• Defining self-pay

  A: We define self-pay receivables as those balances due from patients/guarantors for hospital and...

• CMS helps covered entities understand new HIPAA edit requirements

  Come July 1, your claims will be held to different requirements as specified by HIPAA. In an effort...

Issue 9, May 14, 2004 - VIEW THE FULL ISSUE

• Tip: Revenue cycle communication strategies

  The biggest challenge in overseeing an effective revenue-cycle team is getting people to...

• CMS issues final proposed rule for 2005 inpatient payment increases

  Acute-care hospitals, with a focus on rural facilities, are the target of CMS' latest announcement...

Issue 8, May 7, 2004 - VIEW THE FULL ISSUE

• Writing off deductibles and copays

  A: I don’t know why any provider would want to write off a patient's deductible or...

• Texas has highest percentage of uninsured workers

  Texas leads the nation in the number of working people who have no health insurance, but most...

Issue 7, April 30, 2004

• Use a physician advisor to bridge the communication gap

  It is generally well accepted that case management, utilization management, quality, and patient...

• Reducing data-collection errors

  A: In order to determine how to improve the quality of registrations, it is important to thoroughly...

• Insurance industry consolidation continues with planned $4.9 billion merger

  In a move that would strengthen its position in the Northeast, Minneapolis-based health insurer...

Issue 6, April 23, 2004

• Important provisions to include in your charity policy

  Your policy on accepting patients as charitable cases is an important piece of the revenue cycle...

• ABNS in the ED

  Although the topic of obtaining ABNs in the ED has been in the spotlight, very few facilities are...

• CMS to increase payments to hospitals reclassified under MMA

  CMS announced April 20 that 121 hospitals in 25 states will begin receiving higher payments for...

Issue 5, April 16, 2004 - VIEW THE FULL ISSUE

• Charity, bad debt play role in revenue-cycle management

  Charity, a patient's inability to pay, and bad debt, a patient's unwillingness to pay, plays a role...

• Four patient preprocessing benchmarks reported

  A recent revenue-cycle benchmarking study published by Zimmerman & Associates, a Wisconsin-based...

Issue 4, April 9, 2004

• Four steps for a successful denial management program

  Increasing communication with payers was just one of Kathleen E. Chavanu's objectives in developing...

• Q&A: ASK THE EXPERT - Moving precert to patient access

  A: The pre-cert is the crossroads of financial and clinical information. If a precert is not...

• CMS adds new drugs, technologies to OPPS list

  In a move designed to ease the financial strain on hospitals using new drugs and technologies, CMS...

Issue 2, March 26, 2004

• Outsourcing: Ensure top vendor performance

  There are several components to hiring the right vendor, including your responsibility to ask the...

• Physician communication strategies

  Although the relationship between attending staff and hospital staff is often tenuous, a team...

• Benchmarking study reveals patient preprocessing best practices

  Top-performing hospitals have solid preregistration programs in place, according Zimmerman...

Issue 1, March 19, 2004

• Tip: Identify patient access trouble spots to decrease denials

  The admitting/access process often initiates problems that result in denied claims. By isolating...

• Ask the Expert: AR performance indicators

  Issues caused by various functions or constraints in the revenue cycle are more than likely to be...

• Anthem/WellPoint merger gets DOJ seal of approval

  The Department of Justice (DOJ) announced March 9 that the proposed purchase of WellPoint Health...