Analyze Patient Billing Data to Identify Problem Areas Your patient billing system may already be good – but there is always room for improvement.

Revcycle recommends checking three crucial metrics to identify problem areas within your patient billing system: Average Days from Statement to Payment:In a perfect world, every patient pays on time, and your payment date is soon after your statement date.

As payment dates drag out, payments become increasingly costly to collect.

Consider the number of calls you needed to make, for example, or the time staff spent answering billing questions.

The HFMA emphasizes four foundational principles of a patient-friendly billing system, including: Clear: Bills should be written in plain language.

Concise: Bills should contain the right amount of detail to communicate the message, but not too much detail to confuse customers.

Telehealth isn’t going away any time soon.

Today, we’re highlighting the most important telehealth trends for 2021, including some of the rising and falling movements we’ve seen from telehealth in recent months.

2) Premium Telehealth Services Are Increasingly Becoming Standard Telehealth services that were once considered “premium” are rapidly becoming standard.

We saw authorities relax some regulations at the beginning of the pandemic, and it’s possible we’ll see new regulatory frameworks emerge in the coming months.

Regulatory clarity makes it easier for organizations of all sizes to implement telehealth systems and stay competitive.

It works around the schedules of patients.

Some organizations are managing more effectively than others.COVID-19 has introduced billing and coding challenges, patient financial responsibility issues, and other problems for healthcare organizations.Today, we’re explaining strategies firms are using to manage healthcare revenue cycle management during the COVID-19 pandemic – including how your organization can stay ahead.Medical Coding ChallengesMany organizations have faced billing and coding challenges during the COVID-19 pandemic.To navigate the pandemic, your organization needs to know what is covered by health plans for both inpatient and outpatient care.Rules are changing constantly.

That means staff require frequent training and regular updates to avoid billing and coding problems.Many outpatient facilities are scheduling telehealth appointments, for example.

Check if the insurer needs further documentation or approvals.Billing ChallengesMany healthcare organizations have shifted their billing office to work remotely.

Others do not.Every healthcare organization has some type of emergency plan – but few healthcare organizations were prepared for a multi-month pandemic-related shutdown.You may think it’s too late to address emergency preparedness for the coronavirus pandemic.

Pay close attention to changes in:Copays and Deductibles: Some of America’s largest insurers have changed copay and deductible policies, including out-of-pocket responsibilities for patients.Standard Referral Requirements: Consider standard referral requirements, as this can move payment obligations from the patient to the insurer.By keeping staff trained and up-to-date on patient financial responsibility changes, healthcare organizations can optimize revenue cycles during the pandemic.Other Things to ConsiderHealthcare organizations are dealing with countless challenges during the coronavirus pandemic.

Other things to consider with revenue cycle management include:Capacity Assessment: Hospitals in many states are facing a surge in patients, including surges that overwhelm capacity.

Starting in 2022, however, organizations will switch to the ICD-11 standard.ICD-11 has four times as many codes as ICD-10.

That means new challenges for healthcare providers – and new problems with missed revenue, coding errors, and denied claims.Keep reading to discover some of the significant changes in ICD-11 medical coding, including how your organization can prepare for the release of ICD-11.What is ICD-11?The World Health Organization has created the ICD-10 medical coding standard, which is currently in use in the United States and around the world.

Organizations lose revenue, sacrifice patient care, and face insurance denials, among other issues.

Here are some steps to help your organization get started.1) Become familiar with new ICD-11 codes and chaptersICD-11 has thousands of new codes and chapters.

Many of these codes and chapters have not been seen in previous versions, and they’re totally unfamiliar even to experienced medical coders.There’s a new code for work burnout, for example.

Smart organizations are familiarizing themselves with these new codes and chapters today to avoid surprises in the future.2) Update EHR and revenue cycle management softwareTo prepare for ICD-11, organizations need to ensure they have the latest versions of EHR and revenue cycle management software.Inevitably, during the switch to ICD-11, some organizations will get stuck using older versions of software.

Revenue cycle management optimization companies have been talking about automation for years.

Automation is not a secret, yet many organizations are not investing in automation in the right way.

A strategic approach to investing can work wonders for your organization.

Instead of shoehorning robotic process automation (RPA) into fields where it doesn’t fit, you can target the best opportunities for automation, artificial intelligence, machine learning, and RPA.

How should your organization intelligently invest in automation for revenue cycle management?

Here are some of the strategies organizations are using to maximize their success. 

Securing Domestic Manufacturing of Medicine, Supplies, and Equipment The COVID-19 pandemic showed how fragile international supply lines can be.

As the COVID-19 pandemic surged, countries with domestic medical manufacturing facilities reigned supreme.

Expect a significant “made in America” push in the coming years.

Making Large Investments in Telehealth  Telehealth isn’t going away anytime soon.

It was surging in popularity before the pandemic, and the pandemic illustrated the importance of telehealth even further.

Virtual patient care is more common today than ever – and it’s going to become increasingly common in the coming years.

By capitalizing on changes, and by training staff, organizations can optimize healthcare revenue cycles throughout the coronavirus pandemic.Today, we’re highlighting five ways COVID-19 has impacted healthcare revenue cycles for organizations across the United States – and how organizations are thriving in the face of change.Telehealth Appointments & Coding ChallengesObviously, telehealth has surged in recent months.

Many outpatient facilities have switched to telehealth appointments, giving patients the same quality of care via a safer, remote environment.Telehealth appointments are also introducing coding and billing challenges.

Many organizations have requested billing and other support staff to work remotely throughout the pandemic.Hennepin Healthcare in Minneapolis, for example, recently shifted nearly all support staff to remote positions, including coders, coding educators, coding auditors, coding support specialists, coding coordinators, and transcriptionists, as explained in an interview with HealthLeaders.Remote work has introduced new challenges.

Remote employees also need to consider HIPAA, taking extra care when managing patient data in an unfamiliar setting.With employees using their own equipment, it introduces new challenges.

Good healthcare organizations are staying up-to-date on changes, while other healthcare organizations are lagging behind.In April, the American Medical Association (AMA) announced it was fast-tracking the development of a unique Current Procedural Terminology (CPT) code for coronavirus testing.CMS also released guidance on billing and reimbursement for treating COVID-19.

CMS had previously released two Healthcare Common Procedure Coding System (HCPCS) codes, allowing labs to bill for certain COVID-19 diagnostic tests.These changes can seem confusing, but good coding is the backbone of healthcare revenue cycle management.Long-term Medicare ChangesAs part of an $8.3 billion emergency funding measure passed earlier this year, Medicare now covers telehealth services.

These improvements can benefit the organization’s bottom line, improve patient care, and make it easier for physicians to do their job.Today, we’re explaining some of the ways physicians can benefit from healthcare consulting whether running a small practice or working for a larger organization.Charge Capture Reviews Identify Missed Revenue OpportunitiesHealthcare consultants conduct charge capture reviews.

You may not know how much you’re losing in possible reimbursement until you order a charge capture review.Without accurate charge capture processes in place, potential reimbursement slips through the cracks.

It can increase claim denial rates and waste money at multiple levels of an organization.Many organizations struggle to identify charge capture errors – especially if they’re unfamiliar with the complex nature of charge cycles.

As any healthcare consultant will tell you, charge capture is among the most destructive problems in healthcare reimbursement.As a doctor at a hospital, charge capture review has less of a direct impact on you.

The success of your private practice depends on it.A good healthcare consultant will conduct:• Charge capture reviews• Physician/provider claims reviews• Review of office and inpatient E/M visits coded and billedBy targeting these areas of the organization, healthcare consultants can identify missed revenue opportunities – enhancing profitability for doctors, their practices, and their organizations.Create a Better Environment for Support StaffSupport staff keep an organization running smoothly.

Healthcare consultants know what works at other organizations, and they can recommend actionable changes for your organization to achieve real results.Healthcare Consulting Provides Powerful Returns on Investment Year After YearHiring a healthcare consultant can provide a significant return on investment.

Since digital healthcare isn’t going away any time soon, that’s a problem.

Why is the cloud so valuable?

And hybrid cloud deployments allow organizations to enjoy all of the benefits of the cloud – with fewer downsides than a cloud only deployment.

As pointed out by Forbes, firms like Amazon are taking note.

Amazon Web Services just announced the launch of HealthLake, a cloud storage and analysis platform.

Studies show it can also improve patient outcomes.

However, some are not prepared to handle telehealth coding and billing.Demand for contract medical coding experts is surging.

Companies like HMI Corp can help your organization manage complicated COVID-19-related telehealth coding.

Our coding experts have proven expertise across the United States.Today, we’re highlighting some of the best telehealth coding and billing practices for the COVID-19 coronavirus pandemic, including changes to be aware of.HHS Relaxes Certain Telehealth Rules During COVID-19In response to the COVID-19 pandemic, HHS has relaxed certain telehealth coding rules.

These changes affect critical access hospitals (CAHs), federally qualified health centers (FQHCs), rural health clinics (RHCs), skilled nursing facilities (SNFs), and home health agencies and hospices.You can learn more about the CMS’s COVID-19 emergency declaration blanket waivers for healthcare providers and telehealth services at CMS.gov here.CMS Releases HCPCS Codes for Telehealth ServicesCMS has released a list of HCPCS codes for telehealth services and other virtual patient treatment sessions.These codes are covered under the Physician Fee Schedule, and they will continue to be covered throughout the COVID-19 pandemic.You can view the full list here.AMA Releases Guidance on Telehealth Billing and CPT CodesAMA has released information on telehealth billing and CPT codes, including telehealth visits, online digital visits, remote patient monitoring, and similar telehealth services.AMA’s guideline was updated on May 22 and covers the implementation of telehealth in response to COVID-19, including how to code telehealth services.The goal of the guideline is to help providers implement telemedicine and remote care services while ensuring uninterrupted care for 100 million Americans with chronic conditions.Items covered by AMA guidelines include:• Store and forward technologies that collect images and data for transmission and interpretation at a later date• Real-time, audio-video communication tools that connect physicians and patients• Remote patient monitoring tools like blood pressure monitors, wearables, Bluetooth devices, and other devices that collect biometric data for review (including mHealth apps).• Verbal/audio-only and virtual check-ins via patient portals, messaging platforms, etc.Using Telehealth Services for TriageHospitals are now using telehealth services to triage patients whenever possible, according to a recent report from the Office of the Inspector at HHS.As demand for elective and non-urgent services declines, ambulatory organizations are following similar guidelines.That means demand for telehealth services continues to grow – and the demand for effective telehealth coding guidelines is increasing with it.Other Tips for COVID-19 Telehealth Coding and BillingCOVID-19 has left organizations scrambling.

The AMA, CDC, and CMS are releasing new guidelines regularly, and the COVID-19 pandemic is changing weekly.

Spend extra time checking information from all relevant providers to help your organization stay up-to-date.Spend extra time verifying EHRs to ensure accuracy and compliance.

Artificial intelligence has solved countless human challenges – and medical coding might be next.As organizations prepare for ICD-11, medical coding is about to become more complicated.

Healthcare organizations in the United States already manage 140,000+ codes in ICD-10.

According to a report from Forbes, medical coding with artificial intelligence is closer than you think – and AI is already solving medical coding challenges for organizations around the world.First, it helps to understand what ICD-11 is and why it’s important.International medical organizations currently use the ICD-10 medical coding standard.

WHO member states voted to implement ICD-11 in May 2019, and implementation will begin in WHO member states – including the United States – in January 2022.ICD-11 is a significant change from ICD-10.

It contains four times more diagnostic codes: instead of the 10,000+ codes in ICD-10, healthcare organizations will have 55,000 diagnostic codes from which to choose.In America, medical coding is even more complicated.

Depending on interpretation, there may be multiple ways to code a service.Some suggest using artificial intelligence to help.

While some rural hospitals thrive in challenging situations, others falter.Today, we’re highlighting some of the best success stories of rural hospitals across America, including situations where ingenuity, creativity, and flexibility saved small hospitals in rural settings.Rural Hospital in Beatrice, Nebraska Specializes in Healthcare for Older AdultsRural areas of America tend to have older populations than urban areas.

To address their needs, Margaret Mary Community Hospital has built a rheumatology program specifically catered to the town’s aging population.Like Beatrice, Batesville has an older than average population.

With good healthcare and a low cost of living, Batesville’s future – and the future of Margaret Mary Community Hospital – looks bright.Childress, Texas Hospital Grows in One of America’s Toughest MarketsTexas has been hit particularly hard by the rural health crisis in the United States.

Some of the strategies implemented by the hospital include:• The hospital offers expanded services, which means local residents no longer have to drive two hours to reach the nearest hospital; this approach led to nearly 1,000 new patient visits in the most recent fiscal year• ¬Childress Regional Medical Center has invested in telemedicine units while also increasing the number of doctors and hours at its primary care clinic – all while competing hospitals have taken an opposite approach by cutting hours and serviceBy expanding staff and hours, Childress Regional Medical Center has become the go-to hospital for patients throughout the region.Locals no longer have to travel hours to visit neighboring medical centers, for example, because the hospital hired an orthopedic surgeon in 2013.

The hospital also hired an oncologist who visits the hospital once per month, with specialists in urology and cardiology visiting Childress Regional Medical Center on a similar schedule.The hospital has also received a boost with telemedicine.

Telemedicine allows physicians at Childress Regional Medical Center to consult with specialists at Children’s Medical Center in Dallas, making it easier to handle complex cases.For all of these reasons, Childress Regional Medical Center continues to be a notable success story in a state where rural hospitals face increasing challenges.Haleyville, Alabama Hospital Reverses Closure After Community Funding EffortRural hospitals exist because of their communities.

Today, we’re explaining how Lean Six Sigma works in healthcare – and how it can help your organization eliminate defects.

Since the mid-2000s, however, we’ve seen Lean Six Sigma in healthcare, finance, supply chain, and other sectors.

Good organizations can quickly fix these inefficiencies and move forward.

The purpose of Lean Six Sigma is to identify defects.

Many healthcare consultants are certified in Lean Six Sigma (LSS) methodology.

Certified LSS experts often recommend the DMAIC method, where you Define, Measure, Analyze, Improve, and Control defects within a healthcare organization: Define: The consultant defines the problems with the process and sets goals.

Demand for medical coding companies has surged in recent months.

COVID-19 has revealed medical coding inefficiencies, and firms are struggling to keep up.Good medical coding companies work with healthcare organizations to solve inefficiencies and reduce errors.

Effective medical coding tips helps a company avoid wastage, capture lost revenue, and reduce patient conflicts.Your healthcare organization might have effective medical coding systems in place.

Effective coding and billing helps organizations manage the infectious disease and avoid becoming overwhelmed.The healthcare industry is adapting to COVID-19 and creating new codes for the novel coronavirus.

The pandemic is bringing in new patients with unique needs, creating more coding and documentation challenges for organizations.Below, we’ll summarize some of the guidance released by the CDC, CMS, and AMA in weeks for medical coding during COVID-19.CDC Guidance on ICD-10-CM for Positive COVID-19 Test ResultsThe Centers for Disease Control released new medical coding guidance in March for COVID-19.

This code also applies to asymptomatic patients who test positive for coronavirus.U07.1.1 is a principle or first-listed diagnosis code.

As populations age, this problem is getting worse – not better.Today, we’re highlighting some of the ways that small, rural hospitals can benefit from a revenue cycle assessment.Understand the Unique Challenges Facing Smaller, Rural HospitalsThe first and most important step is to understand the unique challenges smaller hospitals face.

Instead of complaining about these challenges, good rural hospitals have learned to surmount these challenges by optimizing revenue cycles.Get Creative When Attracting PhysiciansSmaller, rural hospitals may already be operating with negative margins, making it harder for them to attract physicians.

With smaller, rural hospitals, that may not be an option.Instead, organizations seek other solutions.Many rural hospitals implement team-based care models that depend on advanced practice clinicians, for example.One 2016 study by the American Academy of Physicians Assistants found hospitals that used a higher physician assistant-to-physician ratio, reduced care costs more than other teams in the same hospital using a traditional staffing model.

A recent MGMA survey, for example, found that implementing physician assistants into patient care led to a 34% boost in productivity compared to similar organizations.While physicians may be the cornerstone of patient care, many rural hospitals are achieving success by switching to a team-based care model.Get the Best ROI from Health IT InvestmentsRural hospitals also face challenges on the IT side.

While larger hospitals have the resources for full-featured IT departments, smaller hospitals do not.

They can use cloud-based health IT systems to boost productivity and enhance patient care – all at a comparable cost to what their larger, more metropolitan competitors are paying.A good healthcare consultant can analyze organizational needs, then recommend and implement the best health IT system.Reduce Uncompensated CareRural areas tend to have higher poverty rates than suburban areas.

Healthcare organizations have many opportunities to train employees and enhance organizational revenue.By taking advantage of these opportunities, healthcare organizations can significantly improve their bottom line.From lean healthcare workshops to continuing education programs to other professional training systems, employee training opportunities can enhance organizational revenue in various ways.Today, we’re exploring some of the best employee training opportunities for small and large healthcare organizations.Lean Healthcare WorkshopsLean healthcare workshops can singlehandedly change an organization’s bottom line.

The idea of running a lean organization is nothing new in and out of healthcare – but healthcare organizations across the country are increasingly taking advantage of lean healthcare workshops to implement new techniques, philosophies, and management systems.Some of the topics covered in a lean healthcare workshop include:• An overview of lean healthcare practices, philosophies, and systems and how they work• How all elements of a healthcare organization work together to create a lean organization• Specific examples of healthcare organizations successfully implementing lean practices to rejuvenate operations• How to identify core problems at a healthcare organization, including specific trouble spots that can benefit from a lean healthcare philosophyBy scheduling a lean healthcare workshop, organizations can discover the best practices modern organizations are using to maximize revenue while minimizing losses.Positive Work Environment WorkshopsMany healthcare organizations recognize the importance of employee revenue training and employee certifications.However, many organizations overlook another crucial aspect of patient care: a quality work environment, good employee relationships, and a good work-life balance.Employee turnover is a significant expense for healthcare organizations.

For employees who make a higher salary, the cost of employee turnover is much higher.The top reasons employees leave a healthcare organization are:• Career development, and an inability to grow or expand their skills at their current employee• Work-life balance, particularly among younger adults or parents• Management behavior, including the way managers treat employees and the things employees expect from managersBy addressing these areas, healthcare organizations are better able to attract and retain talent.One of the best ways to address these areas is with employee training and workshops.

Available training programs include:Stress Management Workshops: Some employers invest in stress management workshops.

These workshops explain how to reduce emotional exhaustion, manage stress, manage anger, and encourage positive thinking.

It makes an employee less likely to leave.