The lack of a robust charge-capture program can have a significant impact on your bottom line. Many organizations neglect to focus on this aspect of the coding and billing process because claims are being submitted and paid. But overlooking missed, incorrect, and inconsistent charges is akin to leaving money on the table.
Before Congress departed for the Fourth of July district work period last week, the Senate Health, Education, Labor and Pensions (HELP) Committee overwhelmingly passed S. 1895, the Lower Health Care Costs Act out of committee. Since the beginning of this year, the Senate HELP Committee has held five hearings on how to reduce healthcare costs and four hearings to explore the rising cost of prescription drugs.
Creating a sustainable revenue cycle occurs with the interaction of a number of important functions, people, and processes, all of which must work in tandem.
Clinical documentation improvement is a provider’s best defense against payment denials, audits, and preserving revenue integrity—which is why the people sitting in the C-suite should know what it is and prioritize it.
There is rare bipartisan momentum in support of several different pieces of legislation aimed at addressing the issue of “surprise medical bills”— exorbitantly high emergency and other medical department bills.
The American Medical Association and United Healthcare have proposed more than 20 new ICD-10 codes for social determinants of healthcare that identify social diagnoses or barriers to healthcare. The proposed expanded codes “would capture these social diagnoses and barrier situations to assist providers and consumers in obtaining routine care, medications, and preventive services that are not captured today, thereby benefiting the industry as a whole in the management of patient care,” states the United Healthcare and AMA proposal in a document made available by the CDC.