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GroupOne Health Source Blog

GroupOne Revenue Cycle Blog 

Insights to guide your practice.

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What are the Elements of a Highly Efficient Claims Process?

by Kaitlyn Houseman on August 16, 2016

Because there are typically multiple parties involved in a medical care claim, the process quickly becomes quite complex, which lends itself to a variety of errors caused by both humans and technology. Developing an efficient claims process is crucial to the success of your medical practice, and the process begins before any claims are even submitted.

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Topics: Revenue Cycle Management, Denial Management

Some Health Insurance Companies Automatically Enrolling Patients In Medicare Advantage Plans

by Keith Lage on August 3, 2016

Whether to sign up for traditional Medicare or with a Medicare Advantage plan may no longer be your decision to make. It turns out that some Medicare-age people are being automatically enrolled in Medicare Advantage plans by something called "seamless conversion."

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Topics: Revenue Cycle Management, Practice Management

The Impact of MACRA on Your Practice

by Jeff Jones, CPHP on July 28, 2016

Encouraging physicians to switch to electronic health records (EHR) has been a long term effort from CMS ever since the January 2009 passage of the HITECH act. Over three-quarters of physicians and nearly all hospitals are using an EHR but the incentivizing structure has been hard to wade through, at best. Now healthcare professionals and physicians alike must focus their efforts on understanding the end of the SGR formula and the beginning of The Merit Based Incentive Payment System and Alternative Payment Models.

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Topics: MACRA, Incentive Programs, Revenue Cycle Management

Medicare Policy Changes in 2016: What You Need to Know

by Kaitlyn Houseman on July 19, 2016

Recent changes to medicare policy will impact your practice and your patients. Here's what you need to know and how you can adjust to the new payment policies.

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Topics: Revenue Cycle Management, CMS

How an EHR Software Can Improve Your Revenue Cycle Management

by Kaitlyn Houseman on July 12, 2016

Medical billing is a complicated system with one simple goal, to ensure that healthcare providers are properly reimbursed for their services. In pursuit of this goal we must take into consideration how an EHR can help practices increase their collections and be more productive. Here we'll cover some common areas where the use of an EHR impacts billing and coding and how your practice can avoid potential errors while maximizing revenue.

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Topics: Revenue Cycle Management, EHR

Why Healthcare Organizations Can't Afford to Ignore Data Management

by Kaitlyn Houseman on July 7, 2016

The data-driven healthcare organization is the one most likely to thrive today. Data analytics is now a top driver for IT spending, with more than one-third of hospitals overall saying analytics drives their IT spending. For medium sized hospitals, that figure is closer to 45%. Treating data as a strategic asset, and analyzing it appropriately can make decision-making more productive. This can lead to reduced costs and improved healthcare delivery. 

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Topics: Revenue Cycle Management

How to Make Sure Patients with High Deductible Health Plans Pay Their Bills

by Keith Lage on July 5, 2016

With more and more patients moving to a high deductible health insurance plan, it is becoming increasingly important to make sure that those patients pay their deductibles on time and in full. Though a portion (ideally no higher than 4 to 6%) will become bad debt and be written off, to keep your practice healthy, you will need to encourage your patients to pay these deductibles and make that payment process easy and as pain-free as possible.

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Topics: Revenue Cycle Management, Self-Pay

Conducting a Mid-Year Checkup of Your Revenue Cycle Management

by Kaitlyn Houseman on July 1, 2016

A healthy medical practice centers around patient care and healthy revenue cycle management. You cannot have one without the other. In this day and age, no matter how good your practice is at keeping your patients healthy, if you don’t also have a healthy revenue cycle, you’re not going to be around long enough to help many patients heal.

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Topics: Revenue Cycle Management

How Can You Reduce Your Accounts Receivables? Try a CCOF Policy

by Kaitlyn Houseman on June 29, 2016

Today, high-deductible insurance plans are more and more standard for patients. According to a recent report from InstaMed, 74 percent of healthcare providers reported an increase in patient financial responsibility in 2015, which has prompted healthcare revenue cycle management strategies to focus more on consumers. This reality makes collections that much more difficult, and practices often encounter patients “forgetting” their checkbooks or credit cards at the time of service. 

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Topics: Revenue Cycle Management, Self-Pay, Practice Management

9 Medical Practice Performance Metrics to Report on During Your Next Meeting

by Kaitlyn Houseman on June 23, 2016

Tracking metrics in your medical practice can result in improved efficiency, profitability, and yield better results across your entire practice and revenue cycle management operations. Choosing what to measure and what to report is as important as deciding to start tracking measurements in the first place. In this post we will cover the 9 metrics that not only measure your RCM performance but the entire pulse of your medical practice.

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Topics: Revenue Cycle Management

Are You Exempt from MIPS? How Advanced APMs Differ From APMs

by Jeff Jones, CPHP on June 15, 2016

Some interesting discussions have emerged since the MACRA proposed rule was announced. One that is acquiring a lot of attention is the eligibility requirements of Advanced APM entities. Under the proposed rule only Advanced APMs will qualify for the 5% annual lump sum payment and be exempt from MIPS. In this post we will dive deeper into what it takes to become an Advanced APM and what happens if an APM entity does not qualify as an Advanced APM.

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Topics: Revenue Cycle Management, Merit Based Incentive Payment System, Incentive Programs

What is an Advanced Alternative Payment Model?

by Jeff Jones, CPHP on June 7, 2016

The MACRA final rule details how Alternative Payment Models (APM) will enhance or replace some of the current fee-for-service payments. While the criterion may seem simple in theory, additional details help clarigy the difference between an Advanced Alternative Payment Model and an Alternative Payment Model.

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Topics: Revenue Cycle Management, CMS, Incentive Programs, MACRA

Is Your Documentation Ready for the End of the ICD-10 Grace Period?

by Kaitlyn Houseman on May 31, 2016

Clinical documentation is at the heart of every patient encounter. It needs to be meaningful, and to be meaningful, it needs to be clear, accurate and timely. Clinical documentation isn't just critical for patient care, it is also used to share critical information with other providers while optimizing the claims process. However, with implementation of ICD-10 from October 2015, provider clinical documentation became much more complex: There are now nearly 70,000 codes, up from nearly 14,000 in the ICD-9.

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Topics: Revenue Cycle Management, ICD-10, Coding

What You Need to Know About the MACRA NPRM

by Jeff Jones, CPHP on May 25, 2016

The Centers for Medicare and Medicaid have released the notice of proposed rule-making (NPRM) for the Medicare Access and CHIP Reauthorization Act. The proposed rule was released in late April and the final rule is schedule to be released in the fall of this year (2016). Here is a breakdown of the MACRA NPRM if you haven't yet had the time to read the entire 962 pages.

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Topics: Revenue Cycle Management, CMS, Merit Based Incentive Payment System, Incentive Programs

[Infographic] The Impact of Nursing Leadership Styles on Patient Outcomes

by Tim Wayne on May 20, 2016

Between declining reimbursement, new incentive programs, and keeping pace with the competitive industry of healthcare, healthcare managers and leaders are in a constant struggle to become more efficient and effective. Healthcare is becoming increasingly complex, and juggling these modern day challenges while still being a good leader and providing effective care for patients can be challenging to say the least.

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Topics: Revenue Cycle Management, Medical Business, Patient Engagement

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