5 Strategies to Improve Your Medical Billing Process

Efficiency is the cornerstone of any healthcare setting. For you to succeed, you must employ innovative ways to deliver quality care and enhance patient experience while lowering your costs and avoiding mistakes.

An efficient medical billing system, therefore, is of paramount importance to achieve these goals. Without an experienced biller working for your practice, it is incredibly difficult to minimize errors, adhere to the latest regulations, and optimize the billing process. And a flawed system could mean not getting paid.

The medical billing process in the United States does not have to remain immensely challenging for both patients and healthcare providers. At Coronis Health, we make sure our partners are 100% compliant and able to receive patients and bill out-of or in-network. We go after the last dollar using our seasoned team of tireless and tough negotiators. We don’t just help you get money, but we help you financially grow. 

A sound medical billing process does not happen automatically, but we can help you get there. We help you employ the right practices to ensure that you reduce debt and unpaid bills while maximizing your profits. Below are five strategies you can use to help improve your billing workflow, helping you maintain financial independence and cultivate success.

#1 Diligently Follow Up With Inquiries

The billing department is in constant communication with various parties, such as insurance companies and patients. Even if bills are sent or emails are exchanged, it is still important to conduct follow-ups to keep track of all the parties’ inquiries and concerns quickly. Without a follow-up procedure, a claim may be denied or your income may be delayed. A successful follow-up procedure can:

• Help maintain a steady flow of revenue, contributing to your financial stability
• Help your practice recover overdue payments without any hassle
• Minimize the amount of time that accounts are allowed to remain outstanding
• Avoid missing claims, which is the biggest reason for delays in payments
• Help recover claims that are still pending due to additional information needed

At Coronis Health, we understand that your most important financial asset is your billed services and accounts receivable. We make sure that this asset is safeguarded, well-organized, tightly managed, and carefully maintained by a professional team possessing a perfectionist approach to execution, accuracy, follow-up, and timeliness. Our United States team works quickly to get billing and A/R follow-up running so you can start collecting and hitting and surpassing financial targets. 

#2 Accurately and Thoroughly Gather Patient Information

Whether you are billing an insurance provider or collecting payment from a patient, everything begins by having accurate information. When you gather all necessary patient information upfront, you’ll avoid a lot of mistakes along the way.

Accurately billing the patient is highly dependent on hiring a front desk staff that is meticulous, organized, and thorough. One way to help the front desk achieve an efficient system is by digitizing your process. Replace old-school questionnaires with tablets that patients can conveniently use to enter their information. By utilizing technology, you get to avoid discrepancies due to poor penmanship or misplaced files. To streamline all your processes, make sure all the financial information your medical billing department handles is easily accessible. Because by knowing where every file and report is, they will save on time and energy.

#3 Be Open About Your Costs

Being upfront about costs will not only inform patients about their financial responsibility, but it also allows the staff to easily ask for payment and to give providers a better understanding of the costs of the services they recommend. Besides, cost transparency will improve customer service and influence patient loyalty, too. This survey shows that patients are more likely to recommend their provider and/or pay a higher portion of the bill ahead of time if they are given an estimate of the cost in advance. It is therefore highly recommended for medical practices to provide patients with a cost estimate to the best of their knowledge.

#4 Dispute Denied Health Insurance Claims

Even when a claim has been coded and filed correctly, there is still a chance it will be denied. In order to get paid, the medical biller will need to follow up with the insurance provider to try and collect the payment. Experienced medical billers will know how to scrutinize a bill and break down each detail. By understanding the language used in the insurance industry, billers can effectively challenge the claim, facilitate an appeal, and negotiate substantial reductions.

Essentially, a medical biller’s job involves more than just issuing bills. They are problem solvers too. They will be in constant communication with patients and insurance providers, especially when payments are late or when something unexpected happens in the billing process. An experienced medical biller will also have the ability to notice any discrepancies in payment. If these payment discrepancies pile up, your practice can lose revenue.

#5 Hire a Medical Billing Professional

Without the assistance of a professional medical billing staff, you might be missing out on valuable income. Hiring the services of a medical billing company is an investment you can make for your practice. Medical billing professionals have years of experience and are specifically trained to understand the medical billing process. As a result, they are able to navigate through various issues that may arise during the medical billing process. Medical billing professionals also know what medical codes to use when filing claims. They can make billing quick, efficient, organized, and accurate. Since they will focus all their time and energy managing your billing, you can focus on providing quality patient care.

But of course, you will want to make sure you are choosing the best medical billing company for your needs–one that is hands-on, experienced, organized, HIPAA-compliant, and will suit your practice’s scale and specialty. 

At Coronis Health, we offer a personal, high-touch service. We have brought together the most innovative and thought-advancing leaders in medical billing and revenue cycle management to progress this industry into the modern, technological age. We seek a level of professionalism and analysis you won’t find elsewhere, helping you increase your revenue and streamline business operations while safeguarding patient relationships in every step of the billing process. We are also technological innovators. We are fully integrated with the latest technologies, helping to improve efficiency and your practice’s overall revenue performance.

Schedule a Medical Billing Consultation 

Coronis Health is comprised of the top medical billers in the United States, pooling their global resources to bring customers the best in medical billing and revenue cycle management. With more than 100 years of combined experience in various niches including hospitals of all sizes, we offer customers tailored solutions and high-touch relationships you won’t find at a “big box” medical billing company. We employ the latest software and techniques so we can input coding instantly, execute collections fast and efficiently, and get that “last dollar” in a cost-effective manner. Get your free financial check up by scheduling an assessment with us today.

To learn more about how you can achieve long-term financial success while providing top-notch patient care, contact Coronis Health today.

from
https://www.coronishealth.com/blog/5-strategies-to-improve-your-medical-billing-process/

Coronis Health Implementing New CHART Payment Model for Rural Healthcare Facilities

The Centers for Medicare & Medicaid Services (CMS) Innovation is launching a new payment model that aims to give a boost to Americans’ access to quality rural healthcare and telehealth services, and to shift U.S. healthcare providers toward more value-based payments.

Specifically, the agency announced on August 11 that the new Community Health Access and Rural Transformation (CHART) Model will help build better healthcare systems by providing up-front investments and capitated payments to healthcare organizations in these rural areas.

Coronis Health is well-prepared for the new payment model implementation for our rural healthcare facilities clients. As a global company that is committed to providing personal, high-touch service, we seek a level of professionalism and analysis you won’t find elsewhere. With 100+ years of combined experience, we can provide cost-effective and fast services to help rural facilities thrive and serve their communities better. We don’t just help you get payments, but we will also help you maintain financial independence and cultivate financial success.

What is the Community Health Access and Rural Transformation (CHART) Model?

From limited transportation options to shortages in healthcare services, Americans living in rural communities face unique needs and challenges when seeking healthcare services. As a result, rural Americans (approximately 57 million) will face worse health outcomes compared to those residing in larger metropolitan areas. According to CMS, it is the goal of the CHART Model to help address these disparities by providing a way for rural communities to transform their healthcare delivery systems by leveraging innovative financial arrangements as well as operational and regulatory flexibilities.

The objectives of the Model are:

• To increase the financial stability for rural providers through more innovative ways of reimbursing providers that provide up-front investments and predictable, capitated payments that pay for quality and patient outcomes
• To remove the regulatory burden by providing waivers that increase operational and regulatory flexibility for rural providers
• To enhance the beneficiaries’ access to healthcare services by ensuring rural providers remain financially sustainable for years to come and to offer additional services such as those that address social determinants of health (e.g., food and housing)

The new Model will include two options for participation (as stated by CMS): 

1. The Community Transformation Track 

CMS will select up to 15 Lead Organizations for this track. A Lead Organization is a single entity that represents a rural community, comprised of either (a) a single county or census tract or (b) a set of contiguous or non-contiguous counties or census tracts. Examples of entities eligible to serve as Lead Organizations include, but are not limited to, state Medicaid agencies, State Offices of Rural Health, local public health departments, Independent Practice Associations, and Academic Medical Centers.

Lead Organizations will be responsible for working closely with key model participants (e.g., including Participant Hospitals and the state Medicaid agency) and driving healthcare delivery system redesign by leading the development and implementation of Transformation Plans with their community partners. The Transformation Plan is a detailed description that outlines the community’s plan to implement the healthcare delivery redesign strategy.

Lead Organizations and their community partners will receive upfront cooperative agreement funding, financial flexibilities through a predictable capitated payment amount (CPA) for Participant Hospitals in a community, and operational and regulatory flexibilities.

2. ACO Transformation Track

CMS will select up to 20 rural-focused ACOs to receive advanced payments as part of joining the Medicare Shared Savings Program (Shared Savings Program). Building on the success of the ACO Investment Model (AIM), the advanced shared savings payments are expected to help CHART ACOs engage in value-based payment efforts that will improve outcomes and quality of care for rural beneficiaries.  A CHART ACO will be able to receive the following shared savings payments:

• A one-time upfront payment equal to a minimum of $200,000 plus $36 per beneficiary to participate in the 5-year agreement period in the Shared Savings Program.
• A prospective per beneficiary per month (PBPM) payment equal to a minimum of $8 for up to 24 months.

Model Timeline

CMS anticipates the Notice of Funding Opportunity (NOFO) for the Community Transformation Track will be available in September on the Model website. The Request for Application (RFA) for the ACO Transformation Track will be available in early 2021. 

The CMS plans to select up to 20 rural ACOs to participate in the ACO transformation track in fall 2021, with the first performance period beginning in January 2022. Up to 15 rural communities will also be selected to participate in the community transformation track in early 2021, and the first performance period will begin in July 2022. 

How Can Coronis Health Assist You With These Changes?

Coronis Health offers specialized financial and billing solutions to not just all types of hospitals and surgical centers, but rural community facilities, specifically. We understand how you provide vital care for communities across the country and how it can be a struggle to keep your doors open or to keep enough staff.

Our team is constantly vigilant and compliant amid the changes that take place in governmental/carrier billing and documentation regulations, compliance requirements, and new payment models. We strive to be not just a vendor for our clients but a true resource. Our clients know that if they have a question or need advice around the revenue cycle, we’re always there to help. We provide monthly education sessions for our providers in addition to one-on-one coaching around specific claims.

Our team goes above and beyond to ensure our rural healthcare facilities clients are receiving the best performance from our team. We constantly search for ways to improve our processes to ensure your revenue cycle is performing at the highest level. We are also proud to be fully transparent in our work. We provide regular reporting and analytics so our rural healthcare facilities clients can be confident knowing exactly what’s happening with their revenue cycle at all times. Coronis works diligently to be proactive in alerting clients of potential challenges as well as making suggestions on how to be more profitable.

Schedule an Appointment to See How We Can Reduce Your Rural Healthcare Clinic Costs Today

We support the goal of empowering rural communities to create a system that will deliver high-quality healthcare services to patients by supporting providers through more efficient payment structures. We can help you navigate these new changes and help meet the needs of your practice. To learn more, contact Coronis Health and schedule a consultation.

Let’s Talk

from
https://www.coronishealth.com/blog/coronis-health-implementing-new-chart-payment-model-for-rural-healthcare-facilities/

Does Your Hospital Qualify For COVID-19 Medicare Pay Hike?

Starting on September 1, hospitals that have cared for patients who are Medicare beneficiaries diagnosed with COVID-19 will see a 20% boost in payments if they prove a positive diagnosis, CMS announced on Aug. 17.

The pay hike comes from a provision in the CARES Act that directed the Department of Health and Human Services (HHS) to increase pay for hospitals caring for these Medicare beneficiaries during the COVID-19 public health emergency.

At Coronis Health, we understand that it is of critical importance for hospital administrators and practice managers to remain constantly vigilant and compliant amid the changing chorus of governmental/carrier billing, documentation regulations, and compliance requirements. With 100+ years of combined experience, our use of industry-leading technology, and our high-touch relationship building, we can provide specialized solutions for your health systems, helping you focus on patient care, maintaining financial independence, and cultivating financial success.

New COVID-19 Policies

The following are the new COVID-19 Policies for Inpatient Prospective Payment System (IPPS) Hospitals, Long-Term Care Hospitals (LTCHs), and Inpatient Rehabilitation Facilities (IRFs) due to Provisions of the CARES Act, from the Centers for Medicare & Medicaid Services (CMS):

• Effective with admissions occurring on or after September 1, 2020, claims eligible for the 20 percent increase in the MS-DRG weighting factor will also be required to have a positive COVID-19 laboratory test documented in the patient’s medical record. Positive tests must be demonstrated using only the results of viral testing (i.e., molecular or antigen), consistent with CDC guidelines. The test may be performed either during the hospital admission or prior to the hospital admission.
• A viral test performed within 14 days of the hospital admission, including a test performed by an entity other than the hospital, can be manually entered into the patient’s medical record to satisfy this documentation requirement. For example, a copy of a positive COVID-19 test result that was obtained a week before the admission from a local government-run testing center can be added to the patient’s medical record. In the rare circumstance where a viral test was performed more than 14 days prior to the hospital admission, CMS will consider whether there are complex medical factors in addition to that test result for purposes of this documentation requirement.
• The Pricer will continue to apply an adjustment factor to increase the MS-DRG relative weight that would otherwise be applied by 20 percent when determining IPPS operating payments for discharges that report the ICD-10-CM diagnosis code U07.1 (COVID-19). CMS may conduct post-payment medical review to confirm the presence of a positive COVID-19 laboratory test and, if no such test is contained in the medical record, the additional payment resulting from the 20 percent increase in the MS-DRG relative weight will be recouped.
• A hospital that diagnoses a patient with COVID-19 consistent with the ICD-10-CM Official Coding and Reporting Guidelines but does not have evidence of a positive test result can decline, at the time of claim submission, the additional payment resulting from the application at the time of claim payment of the 20 percent increase in the MS-DRG relative weight to avoid the repayment. To do so, the hospital will inform its MAC and the MAC will notate the claim with MAC internal claim processing coding for processing. The Pricer software will not apply the 20 percent increase to the claim when that MAC internal claim processing coding is present on a claim with the ICD-10-CM diagnosis code U07.1 (COVID-19). The updated Pricer software package reflecting this change will be released in October 2020, and additional operational guidance will be provided in implementation instructions in the near future.

Why Seek Assistance From a Healthcare Revenue Cycle Management Company

Keeping the billing office running during this pandemic is key to keeping all types of hospitals and surgical centers open for infected patients requiring care. We know this can be a challenge, especially for independent and smaller organizations, as well as critical access hospitals. By outsourcing your billing and coding, you can focus on your patients while we handle the coding for you. Coronis Health’s is an experienced medical billing and coding company well-versed with the most current changes in healthcare laws and regulations. This way, you can be sure your coding is being handled accurately and that you’re being compensated appropriately for the services you provide. Our use of cutting edge tech, personalized service, and global capabilities means you’re receiving unprecedented care and attention.

At Coronis Health, we know that your most important financial asset is your billed services and accounts receivable. This asset needs to be safeguarded, well-organized, tightly managed, and carefully maintained by a professional team possessing a perfectionist approach to execution, accuracy, follow-up, and timeliness. We will deliver exceptional, personalized service, and with our scalable capabilities, we can service your practice as it grows.

Find Out How Coronis Health Can Serve You

COVID-19 is creating challenges not just around the healthcare revenue cycle but also in resource allocation and patient financial responsibility. To learn more about how a healthcare revenue cycle management company can be of assistance to your hospital during this time and how our thought leadership can help your medical practice reach the next level of financial success, contact Coronis Health today and schedule your free financial checkup.

Let’s Talk

from
https://www.coronishealth.com/blog/does-your-hospital-qualify-for-covid-19-medicare-pay-hike/