Analysis and Management Report monthly meeting to provide any changes or updates to the plan. Inter-company web-links or message boards allow administrators to effectively communication benchmark data and provide progress for both staff and stakeholders. Financial and Reimbursement Strategies There are a number of reimbursement strategies that would help low-and-high- performing health systems maximize payments and lower kickbacks. Collecting the accurate patient information prior to services rendered is pertinent not only for the front-end and back-end but for every individual involved in the care of the patient. The front-end staff should validate patient information at the initial call as well as office visit to make sure the personal information and insurance information is correct in the system. Providing a chart-flag to notify front-end and back-end staff that a patient has an outstanding balance, this will increase communication with the patient so that the balance can be paid or referred to the collections department. In addition to collecting patient information, the co-payment for insurance should be collected at the time of the visit to decrease the risk of non-payment. In order to increase cash on hand and decrease days in accounts receivable, all patient co-payments should be verified at the time the appointment is scheduled. One way to reduce claims errors is to implement technology that allows billing professionals to catch potential denials or errors before the claim is submitted. North Valley Hospital in Whitefish, MO was able to reduce AR days to 42.65 by implementing a EHR system through Paragon to integrate with financial solutions after five years of implementation. (Auten, 2018) Utilizing technology software programs to monitor claims allows professionals to prepare and prevent claims being denied in the future. 18
Analysis and Management Report References Auten, A. (2018). How one critical access hospital reduced its AR days by 40%. Modern Healthcare. Retrieved from - critical-access-hospital-reduced-its-ar-days-by-40 Benson, H. R. (1994). An introduction to benchmarking in healthcare. Radiology Management, 16 (4):35–39. Bragg, S. (2019). Accounts receivable days. Retrieved from Casto, A. B., & Forrestal, E. (2015). Principles of Healthcare Reimbursement (5th ed.). Chicago, IL: American Health Information Management Association. CMS (2018). National Health Expenditures 2017 Highlights. Retrieved from - Reports/NationalHealthExpendData/downloads/highlights.pdf CMS (2018). CMS achieved improper payment rate reductions in Medicare Fee-For-Service (FFS), Medicare Part C, Medicare Part D, Medicaid, and Children’s Health Insurance Program. Retrieved from - improper-payment-rate-reductions-medicare-fee-service-ffs-medicare-part-c-medicare- part 19
Analysis and Management Report Department of Health and Human Services (2014). Improper payments for evaluation and management services cost Medicare billions in 2010. Retrieved from
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