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GroupOne Health Source Practice Management Blog

      

The GroupOne Health Source Blog

 Answers and Insights Every Healthcare Professional Needs.

 

Managing the Revenue Cycle: 7 Areas for Improvement

by Ricki Ransom on May 12, 2016

Did you know that an underperforming revenue cycle causes US doctors to leave around $125 billion per year on the table? Being successful in the healthcare industry requires not only outstanding patient care but also an efficient revenue cycle management process. While some practices excel at both, others are struggling to develop an RCM process that is efficient and profitable.

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Topics: Revenue Cycle Management

5 Ways to Increase Physician Referrals to Your Practice

by Ricki Ransom on April 28, 2016

Independently owned clinics - particularly specialty clinics - may find the process of getting physician referrals to be daunting. There are multiple reasons for this. For one thing, the number of specialist categories has grown in the past decade, so there are more types of specialists for patients to be sent to. At the same time, there are more multispecialty groups that refer to specialists within the group, while many smaller clinics are being purchased by hospitals where internal referrals dominate.

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Topics: Revenue Cycle Management, Medical Business, Practice Management

How to Prepare for Thousands of New ICD-10 Codes

by Toshya Griffin, CPC on April 19, 2016

The shift from ICD-9 to ICD-10 brought some big challenges to healthcare. To help relieve some of these transition difficulties, the CDC and CMS instituted a freeze on updates to the codes prior to the October 1, 2015 implementation date, according to the American Hospital Association. But now, CMS has lifted the freeze and announced they will be adding a host of new diagnostic and hospital inpatient procedure codes (5,000+ new codes) to ICD-10 for fiscal year 2017.

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Topics: Revenue Cycle Management, ICD-10

Communicating About Co-Pays to Patients

by Ricki Ransom on April 11, 2016

Increasing plan deductibles might be a sound solution to slowing health care cost growth, but these high deductible health plans pose a new array of challenges to healthcare revenue cycle management. The number of people covered by an employer-sponsored high-deductible health plan (HDHP) is growing while almost 90% of enrollees in Affordable Care Act (ACA) in Affordable Care Act (ACA) Marketplaces have a HDHP. Communicating financial responsibilities to your patients is no longer optional, it's essential.

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Topics: Revenue Cycle Management, Practice Management

Healthcare Metrics You Need to Track in an Age of Value-Based Payment

by Ricki Ransom on April 5, 2016

The incorporation of value-based payment into healthcare revenue cycle management is one of the defining narratives of this era of healthcare in the United States. The Department of Health and Human Services hopes to shift its payment system to nearly one-third value-based this year, with 50% of its payments to be value-based by the year 2018. Furthermore, it expects nearly all fee-for-service health plans to include some degree of value-based components by then.

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Topics: Revenue Cycle Management, Value-Based Reimbursement

5 Mistakes to Avoid When Hiring a Medical Billing Service

by Adrienne Schrimpf on March 24, 2016

Your healthcare practice holds a great deal of responsibility in providing quality care to your patients. Making the strategic decision to outsource your billing is supposed to make your practice run more effectively, not generate more stress and administrative oversight.

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Topics: Revenue Cycle Management

Strategies to Turn Patients Into Bill-Paying Customers

by Ricki Ransom on March 22, 2016

Revenue cycle management is a complex interaction of services, billing codes, benefit analysis, and successful invoicing. Historically, hospitals and most other providers received 90% of their reimbursement from insurance plans, with the patient portion receiving significantly less concern, since it was traditionally such a small part of overall revenues.
  
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Topics: Revenue Cycle Management, Self-Pay

5 Common Reasons for Claim Denials

by Ricki Ransom on March 21, 2016

When a patient's insurance claim is denied, not only can your cash flow be affected, the relationship with your patient can be damaged as well. Some claim denials can be successfully appealed, but even when appeals succeed, they can temporarily leave claim status up in the air - something both your practice and your patient would like to avoid.

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Topics: Revenue Cycle Management, Denial Management

Fee Schedule Dos and Don'ts

by Renzi Russell on March 17, 2016

What if I told you that your practice is missing out on revenue because of an outdated fee schedule? Would you know how to fix it? Unfortunately, many practices are losing revenue because of their fee schedule and they don’t know that updating it would improve their bottom line.

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Topics: Revenue Cycle Management

4 of the Top Challenges Healthcare CFOs Face (And Their Solutions)

by Keith Lage on March 16, 2016

Does any other industry face the extreme financial pressures healthcare providers routinely take on? Add to those pressures the Medicare and Medicaid cuts, healthcare IT changes, and new reimbursement methodologies, and the healthcare CFO has more on their plate than ever. Not only must CFOs deal with budget crunches and shrinking reimbursement, they have to do what every business CFO does and ensure their hospital or healthcare facility remains financially healthy.

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Topics: Revenue Cycle Management

How Medical Transcription is Bridging the ICD-10 Documentation Gap

by Kaitlyn Houseman on March 8, 2016

It's been several months since the ICD-10 transition deadline, but that doesn't mean that every practice and hospital is fluent in ICD-10 just yet. With the number of codes increasing considerably from ICD-9 to ICD-10, and with longer codes that include far more specificity, it will take time for ICD-10 codes to become free-flowing and automatic, even among experienced coders.

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Topics: Revenue Cycle Management, ICD-10, Transcription

Are You Undercoding Out of Fear of an Audit?

by Toshya Griffin, CPC on February 16, 2016

Declining reimbursement is one of the biggest challenges physicians face today. Ask any physician and they will tell you about the daily struggle of getting paid for their services. However, many physicians are leaving a significant amount of money on the table by undercoding.

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Topics: Revenue Cycle Management, Coding

6 Red Flags That You Chose the Wrong Billing Company

by Adrienne Schrimpf on February 16, 2016

Choosing a billing company is a big step. The quality of your billing services can make a big difference in your practice revenues, for good or bad. Choosing a billing company that turns out to be wrong for your needs can be an expensive mistake that isn't just hard to recover from but also hard to recognize until it's too late.

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Topics: Revenue Cycle Management, Practice Management

4 Core Benefits of Effectively Managing Your AR

by Ricki Ransom on February 11, 2016

Developing a clear strategy for managing accounts receivable (A/R) is a step that isn't easy, but that has significant, noticeable payoff. When a medical practice doesn't track A/R consistently, the average number of days accounts spend in A/R increases, which means the practice is not collecting what it is owed as efficiently as it could be.

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Topics: Revenue Cycle Management

Top 5 Causes of Recurring Claim Errors

by Ricki Ransom on February 4, 2016

Preventing claim errors has always been an ongoing effort for healthcare facilities. Today, more than ever, providers are having a harder time getting paid for their services. In fact, 40% of physicians plan on focusing more on improving the billing and collections process over the next year1. Understanding the top causes of recurring claim errors is a good place to start if you are planning on revamping your RCM processes for better results. 

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Topics: Revenue Cycle Management, Denial Management

Are You Ready for Self Pay Patients in 2016?

by Kathy Kuhn on January 14, 2016

Today's American healthcare consumer is responsible for paying almost 35% of his or her own medical expenses - triple the amount paid out of pocket in 1980. This has led to a major shift in medical practices today focusing more on patient pay strategies. Now that we are in a new year and patients will be back at zero when it comes to meeting their deductibles, practices need to take collecting from patients very seriously or prepare to lose revenue.

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Topics: Revenue Cycle Management, Self-Pay

5 Ways to Find RCM Tools That Grow With Your Practice

by Keith Lage on January 11, 2016

Perhaps there was a time when you could argue that revenue cycle management tools were only worthwhile for large practices with big budgets. All that has changed, however. In fact, a small or new practice may benefit disproportionately from having excellent revenue cycle management tools.

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Topics: Revenue Cycle Management, Practice Management

Should Your Practice Charge No Show Fees?

by Ricki Ransom on January 4, 2016

The estimated no-show rate for medical practices is around 5 to 7%. That may not sound bad, but if you consider each missed visit prevents your practice from collecting an average $25 co-payment and $90 reimbursement from a health plan, one or two no-shows per day adds up to tens of thousands of dollars in lost revenue every year.

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Topics: Revenue Cycle Management, Practice Management

6 New Medicare Codes Primary Care Doctors Can Use to Increase Payments

by Toshya Griffin, CPC on December 30, 2015

What if we told you there was a way to potentially earn tens of thousands of dollars more from Medicare all while improving patient care? It isn't tied to pay to performance measures or linked to alternative payment models either. 

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Topics: Revenue Cycle Management, Coding

Most Commonly Unexpected Denied Procedures

by Kaitlyn Houseman on December 23, 2015

Claim denials are an unpleasant fact of life, and too many of them can dramatically impact your practice's cash flow. Not only do coders have to cope with murky and complicated rules for coding and documentation but at the same time they have the threat of an audit hanging over them, and it's not easy.
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Topics: Revenue Cycle Management, Coding, Denial Management