Why Outsourcing Ophthalmology Medical Billing Is the Smart Choice

Are you considering partnering with an ophthalmology medical billing company for your facility? There are multiple reasons why outsourcing can help your practice increase its productivity, efficiency, and profitability.

Outsourcing Your Medical Billing Can Free up Time and Resources for Your Ophthalmology Facility

Those working in the ophthalmology industry often wear many hats while providing comprehensive care for their patients. They may perform a wide range of duties that are beyond the scope and competency of their profession, including billing services. However, managing medical billing can easily become a full-time job. 

To handle patient data and billing accurately and timely, you will need a dedicated team of experts who can ensure a smooth and efficient workflow. By outsourcing your ophthalmology medical billing services, you can save your staff precious time when it comes to managing EMRs. The extra time and resources can be allocated to other responsibilities, primarily for caring for your patients.

Outsourcing your medical billing and coding for ophthalmology services will also eliminate the cost of managing an in-house staff. The money saved can be used to streamline internal processes and enhance overall patient care.

An Ophthalmology Billing Partner Can Help Manage Your Revenue Cycle

A billing partner can bring knowledge and experience in revenue cycle management (RCM), including a team that can work with you to achieve your financial goals. Your billing partner will handle billing and collections, accelerate reimbursements, reduce costs, avoid denials, improve your bottom line, and improve the patient experience.

Your RCM and medical billing ophthalmology partner may provide the following services: 

• Denial management
• Coding assistance and claim scrubbing
• Charge entry
• Collections
• Staff training and best practices

Results of an optimized revenue cycle include:

• Increased revenue
• Decreased days in AR
• Reduced denials
• Higher average encounter rates
• Accelerated and steady cash flow
• Increased clean claim rates
• Lower processing costs per claim

The Importance of Accuracy and Efficiency in Billing for Ophthalmology Facilities

Efficient medical billing is as essential as patient care for your ophthalmology practice. The following are the top reasons why it is vital to remain compliant and accurate in billing all of the time:

• Cleaner claims – Efficiency in ophthalmology medical billing codes will result in cleaner claims, increased first-pass rate, and reduced denials. By maintaining accurate billing protocols, you can ensure your facility remains compliant and financially protected while reaping the benefits of a healthy bottom line.
• Patient protection – Accurate medical coding and billing for ophthalmology services protect your patients. The use of accurate medical billing codes not only helps assess the patient’s health but also aids in improving the quality of healthcare overall. Medical coding is used to keep track of everything from diagnosis to treatments performed, and patients may need access to this information. Inaccuracies can harm the patient and impact the quality of future care. 
• Improved business decisions – Efficient, accurate billing allows your practice to make more intelligent future decisions. You gain the tools needed to analyze data on costs, revenue, write-offs, etc., allowing you to make informed decisions about business and how to maintain your financial independence in the future –whether these business decisions involve staffing or adding more services to your practice. 

How to Choose the Right Ophthalmology Billing Partner for Your Facility

Here are some critical tips to remember as you select a company that will partner with you to boost your bottom line:

Expertise in your specialty

Ophthalmology comes with unique billing and coding challenges. This means it’s important to find a medical billing company that has coding expertise in your type of practice. They’ll have a better knowledge of your specialty’s requirements for documentation, coding, compliance, and more. Failure to go with a company that has expertise in your specialty may result in coding inaccuracies and claim denials.

Revenue cycle management support

You need a partner that can support your facility throughout the entire revenue cycle management process – from before a patient’s appointment to the final reimbursement for claims. The vendor you choose must excel at every stage of revenue cycle management, including claim submissions, follow-up, payment processing, patient invoices, accounts receivable follow-up, and more. 

Security

The company you select must securely handle all your data (you will be entrusting them with sensitive patient and financial data). Top companies can provide secure, HIPAA-compliant billing processes to ensure that your data is kept confidential. Companies will also prioritize transparency so you know exactly what is going on with your finances at all times. In addition, you want to know the company you choose is really fighting for every dollar and that you can see those efforts every time you look at your books. 

Customer support

Work with a billing company that offers quick responsiveness and customer support when you need it, especially when you face problems along the way. You will always need quality customer support and helpful resources to enable you to achieve consistent success.

Quality for your money

While you want to find a competitive price, you also need to know exactly what you are paying for. The cost of outsourcing can vary based upon the specific size and scope of your facility. When discussing the cost of services with a vendor, examples of things you’ll consider would be the specific services included each month, any additional clearinghouse fees, or charges for co-pays.

By bringing together the best healthcare revenue cycle management and medical billing professionals, Coronis Health has the workforce and technology to provide the most current and innovative solutions to optimize the billing process, minimize errors, lower your costs, and comply with the latest regulations.

Ready to Partner With Ophthalmology Medical Billing Experts? Contact Coronis Health Today!

Outsourcing your billing and coding is one of the most significant financial decisions your facility will ever make. Use this information to make the right decision, so you find a company that will help you achieve your financial goals. To learn more about how Coronis Health can help you achieve your bottom-line objectives, contact us today to request your free financial check-up.

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https://www.coronishealth.com/blog/why-outsourcing-ophthalmology-medical-billing-is-the-smart-choice/

5 Anesthesia Billing Tips Every Medical Facility Should Know

Anesthesia providers face several unique billing challenges that make the process more involved and complex than what many other healthcare providers experience. 

Navigating these difficulties is crucial to any facility’s financial health. Below are 5 anesthesia medical billing tips to help you achieve compliance and safeguard payer reimbursement.

Understand the Different Types of Anesthesia and Their Billing Codes

Anesthesia services include but are not limited to pre-operative evaluation of the patient, administration of anesthetic, other medications, blood and fluids, monitoring of physiological parameters, and other supportive services. 

Anesthesia codes in medical billing describe a general anatomic area or service which usually relates to several surgical procedures.

Make Sure You’re Using Correct Modifier Codes to Accurately Bill for Anesthesia Services

Any claim for a healthcare service must clearly define what service/procedure was performed and why it was done.

Modifiers refer to the two-character indicators that help identify relevant details on a claim. Modifiers and codes are essential to increasing accuracy in reimbursement and coding consistency. They also help avoid duplicate billing and unbundling.

The Healthcare Common Procedure Coding System (HCPCS) code set indicates modifiers that are specific to anesthesia care and are required on claims submitted to Medicare and many other payers. 

Know When to Use Global Billing Codes

The global period refers to the timeframe that covers the necessary services performed by a surgeon during the pre-operative, intra-operative, and post-operative stages of a procedure. This also includes any necessary services performed by members of that surgeon’s team. These services are included in the reimbursement of the original surgery, and they cannot be separately reported.

Under the global surgery rule, all the work surrounding and related to a surgical procedure are grouped into a single claim.

Understanding the specifics of the global surgery process is essential to ensure maximum reimbursement for your services rendered. 

View the Global Surgery booklet here.

Use Appropriate Anesthesiologist Modifiers to Ensure Accurate Billing

Modifiers are important because they provide additional information and details concerning a procedure or service provided by an anesthesiologist. Modifiers help further describe a procedure by clarifying whether a service was personally performed, medically directed, or medically supervised by an anesthesiologist. 

These modifiers are required to process a claim, so accuracy is imperative.

Examples of HCPCS Modifiers used in anesthesia medical billing and coding are:

• AA – Anesthesia Services performed personally by the anesthesiologist
• AD- Medical Supervision by a physician: more than 4 concurrent anesthesia procedures
• QK- Medical Direction of two, three, or four concurrent anesthesia procedures involving qualified individuals
• QX – Qualified nonphysician anesthetist service: With medical direction by a physician
• QY – Medical direction of one qualified nonphysician anesthetist by an anesthesiologist
• QZ – CRNA service: Without medical direction by a physician

Understand How Anesthesia Services Are Reimbursed by Insurance Companies

To be reimbursed for anesthesia services, you have to bill insurance companies.

For commercial insurance companies, the following formula is used to report time units for provided anesthesia: Base Units + Time + Physical Status Modifier = Total Units
For Medicare, the following formula is used to report time units for anesthesia provided: Base Units + Time = Total Units

Anesthesia is calculated at 15-minute intervals (15 x 4 = 60). When a case runs over seven minutes, guidelines state to round up to the next 15 minutes provided. 

Insurance companies reimburse for anesthesia services billed with codes and modifiers in accordance with the guidelines provided by The Centers for Medicare & Medicaid Services (CMS) and state guidelines/regulations.

Questions about Anesthesia Billing Services? Contact Coronis Health Today!

Coronis Health is a global revenue cycle management company offering specialized solutions to healthcare practices and facilities. By using industry-leading technology combined with high-touch relationship building, Coronis Health allows healthcare practitioners to focus on patient care, maintain financial independence, and cultivate financial success.

Medical billing for anesthesia is no easy feat. Coronis Health can help manage the process by handling its complexities and avoiding errors. To learn more about our anesthesia medical billing services, contact Coronis Health and request your free financial checkup today.

from
https://www.coronishealth.com/blog/5-anesthesia-billing-tips-every-medical-facility-should-know/

How to Ensure Billing Compliance in Anesthesia

From improving documentation efficiency to educating your staff on new policies, there are proactive steps you can take to ensure regulatory compliance in anesthesia medical billing.

At Coronis Health, we never underestimate the importance of compliance when it comes to anesthesia medical billing. We understand how centralized technology tools that help achieve accurate medical billing and an organized workflow allow you to have confidence in your compliance. Regulatory requirements are complex and ever-changing, requiring your team and any service provider to stay abreast of potential compliance issues. 

Below are tips on how to stay on top of regulatory compliance.

Understand the Billing Process for Anesthesia Services

Medical billing for anesthesia services can be more problematic than surgeon or hospital charges. While accurate documentation is essential to billing, compliance, and reimbursement for every type of healthcare specialty, the process can prove more complex for anesthesia facilities compared to other providers.

Surgeons, for example, only have to use a single CPT code to cover all necessary services from pre-op to post-op. Anesthesia medical billing and coding, on the other hand, is not as straightforward. Anesthesia services are uniquely calculated based on the following criteria:

• Base units – These reflect the complexity of the surgical procedure. Each procedure has a corresponding code with a base unit value. More difficult procedures that require a higher skill level will have a higher base unit. 
• Time units – A time unit is usually 15 minutes in length, but the valuation can change by contract. Time accrues while the physician assumes patient care, remains in attendance caring for the patient, and continues until the patient is no longer under their care and the report has been completed.
• Modifying units – Emergencies and certain conditions in a patient’s health are considered modifying units. 
• Conversion factor – Specific to the provider’s location, this cost is assigned to each unit.

Follow Coding and Documentation Guidelines to Ensure Accurate Billing

To maintain compliance, you will need to:

• Know the correct modifiers – Modifiers refer to the two-character indicators that help identify relevant details on a claim. Accurate usage of modifiers will help ensure proper claims payment. Modifiers also help avoid duplicate billing and unbundling. 
• Report qualifying circumstances – If particular services are deemed necessary and reasonable, qualifying circumstances can be submitted to the insurance provider. Compliance improves due to more accurate documentation of the patient chart. 
• Append physical status modifiers – These are used for reporting the patient’s overall physical health (ranging from a healthy patient to an organ donor) at the time of encounter or procedure.
• Accurately calculate the time for anesthesia administration – Because anesthesia services must be precise, you must document the exact number of hours and minutes from start to finish. For commercial insurance companies, this is the formula used to report time units for anesthesia services: Base Units + Time + Physical Status Modifier = Total Units

For Medicare: Base Units + Time = Total Units

By being meticulous about documentation and coding, your facility will increase efficiency and compliance in medical billing, resulting in proper reimbursement and an optimized cash flow.

Make Sure Your Staff Is Properly Trained

Billing for anesthesia procedures demands that you are more than just familiar with current requirements. Knowledge is power, as the saying goes. You must constantly educate your staff about regulatory compliance and patient safety goals. 

The anesthesia industry, just like other medical fields, is always rapidly evolving –whether in the form of new drugs and devices or approved pain management strategies. You and your staff must keep up with the new guidelines, policies, and patient safety information that go along with these changes, as well as understand and be able to execute what is expected when it comes to processes and documentation. Educate and train your staff to not only stay compliant but to maintain or improve your facility’s organization and efficiency as well.

Use an Automated Anesthesia Billing System to Streamline the Process

You must not only work hard but also work smart. A facility with an optimized workflow runs like a well-oiled machine that enables steady collections while lowering the administrative burden on your staff. An automated anesthesia billing system, in particular, can help streamline all system facets, such as coordinating front and back communication and eliminating lost paper documentation. This allows you to focus on delivering quality care.

When you automate your process, you can bring efficiency to the system so payments are made in a timely manner, while minimizing errors and denials and improving your cash flow. 

If you utilize an Electronic Health Record (EHR) system, for example, you can simplify your facility’s workflow. Improving tasks, such as scheduling, coding and billing, and payment processing allows you to improve efficiency and meet your revenue goals. 

A cutting-edge billing system also updates regulatory changes and contains relevant compliance requirement information that is useful to your facility.

Stay Up-To-Date on Changes in Reimbursement Rates and Other Billing Regulations

Remain updated with all HIPAA policies, guidelines, procedures, and new anesthesia codes in medical billing to avoid claim denials –even fines and lawsuits. 

The law is complex and remaining compliant requires regular review and education. Managing compliance is also an around-the-clock endeavor. Facilities must always be vigilant to address ever-changing regulations, improve healthcare quality and safety, mitigate risk, enable accurate billing and coding, ensure timely reimbursements, and keep patients safe. 

Regularly Audit Your Anesthesia Billing Records to Ensure Accuracy

An audit will examine your current processes and performance, covering all facets of anesthesia medical billing services, from medical coding and patient eligibility verification to claims submission and denial management practices. An audit evaluates records and processes to identify areas requiring improvement or special attention.

Regular auditing will help educate your staff on regulatory compliance. And when everyone follows proper procedures with accuracy, you can better achieve your goal of efficiency, optimized revenue, and safe, high-quality patient care.

Questions about Anesthesia Billing Services? Contact Coronis Health Today!

A compliant facility is an empowered one. If you’d like to learn more about how you can stay fully optimized and compliant, contact Coronis Health to request your free financial checkup today.

from
https://www.coronishealth.com/blog/how-to-ensure-billing-compliance-in-anesthesia/

How to Optimize Your Lab’s Billing and Revenue Cycle Management

Maintaining your facility’s revenue requires a high level understanding of the complete revenue cycle, from the moment a patient presents, to the point at which you receive payment from the insurance company and patient. You can optimize your laboratory’s billing and revenue cycle management by working with an expert that knows your specific needs and how to meet them. When you partner with Coronis Health, you gain more than just a better understanding of billing and revenue cycle management.   

Work With Your Revenue Cycle Management (RCM) Partner to Optimize Billing and Collections

The billing process – for medical or laboratory facilities – is a complex and lengthy endeavor, especially if the facility is consistently busy with a high volume of patients. When you outsource your laboratory billing, you can rest easy knowing that you have more than a billing office at your disposal – you have a revenue cycle management partner that guides you in the optimization of your billing and collections, and ultimately the optimization of your bottom line. 

Think of revenue cycle management as a fluid process, like a relay race around a track. The runners depend on one another to hand off the baton and finish the race. Your partnership with expert laboratory billers and coders will ensure that your relay race – your billing and collection process – is optimized to gain the most out of your reimbursements. Coronis Health has the experts you need to guide you through every step in the revenue cycle process, from analyzing codes to submitting claims and finalizing patient collections.

We work quickly – just like runners depend on one another to keep the pace, providers can depend on us to create the most efficient billing process for your facility. The finish line is in sight, so partnering with a strong runner will guarantee that your claims are clean, your reimbursement is optimal, and your collection rate is in first place.  

Implement Best Practices for Patient Payment Collection

Insurance payers reimburse facilities at a contracted or set rate, and once that payment is determined and charges are adjusted, the patient may be left with some responsibility to pay a remaining balance. This may result from only partial coverage of a laboratory test, or the test not being covered at all. The following are some best practices to help guide your team when talking to patients about making payments:

• Educate your staff – When your team understands the nuances of speaking with a patient about a bill, the patient is more likely to listen and comply.
• Effective communication with patients – Engage the use of the patient portal. Eliminate long hold times on the phone, and maximize the use of your facility’s technology to benefit the patient.
• Payment technologies – Debit cards and automatic payments help to streamline your billing process, and adds convenience for the patient. If you have a patient portal or can store payment information for future bills, give your patients the option to use every convenience possible. 

Use Technology to Improve Billing and Collections Processes

Billing technology is advancing as fast as the technology labs used to analyze specimens. In an effort to improve your facility’s billing and collections processes, Coronis Health uses technology that sees far beyond the old school billing process with paper claims and the check in the mail. 

• RCM Clarity to integrate laboratory information systems with billing software
• Integration with multiple electronic health record platforms, such as Epic, Cerner, NextGen, eClinicalWorks, and many more
• Benchmarking and dashboards to provide high-level analysis for your profitability, opportunities, and threat analysis, including accounts receivable information, payer statistics, and billing performance
• Incorporating the technological knowledge from billing and coding experts who are former lab professionals

Coronis Health strives to provide quality service through the entire billing and collection process, and we do this by creating a unique platform that caters to your facility and its services. Between our expert teams and our top of the line technology, we offer the opportunity to improve your revenue cycle by maximizing your collection rate and streamlining your billing. Coronis Health’s expertise, technology platforms, and passion for quality is the perfect package for your laboratory billing needs. 

Questions About Optimizing Your Lab’s Billing and RCM? Contact Coronis Health today

Your patients demand quality service and an excellent experience from your laboratory. You should demand the same from your billing team, and Coronis Health can do both and more. To learn more about how you can optimize your billing and revenue cycle management, don’t hesitate – contact Coronis Health and find out how you can start your journey to a healthier revenue cycle management partnership with an expert laboratory billing team.

from
https://www.coronishealth.com/blog/how-to-optimize-your-labs-billing-and-revenue-cycle-management/

How outsourcing your laboratory billing services can maximize reimbursements

Medical billing is known to be a complex process, requiring a dedicated and skilled team of billers and coders to create efficiency and success with revenue cycle management. Coronis Health provides outsourced medical billing for primary and specialty physicians, hospitals, behavioral health – and also for laboratory services. If you want to maximize your reimbursements and eliminate the administrative burden of billing for your laboratory services, Coronis Health can provide you with better reimbursement and peace of mind so you can focus on what counts – your clients and patients.. 

The benefits of outsourcing your laboratory billing services

Outsourcing your laboratory billing is a logical step towards creating more than just efficiency in your facility – it is the best step you can take to ensure that you are receiving the most out of what you do every day. From clean claims, to lowering your days in accounts receivable, to increasing your overall reimbursements, outsourcing your medical billing is creating the optimal environment for your finances. 

You can benefit more than you think from outsourcing your laboratory billing as well:

• Timely claim resolution and better data supplied for analysis 
• Improve efficiency and create optimal strategies for growth
• Increase cash flow by improving and streamlining your operational processes
• Reduce or eliminate billing and coding errors – more accuracy equals better data to analyze
• Automated verification of benefits and eligibility

• A dedicated team of billers and coders who are consistently updated on adjustments with coding and regulatory changes
• Faster reimbursement – Your team will process claims quicker than an in-house billing team that may be tasked with other responsibilities outside of their billing tasks. . 

How to maximize reimbursements through accurate and timely billing

Your team at Coronis Health has a goal to ensure your claims are accurate and submitted in a timely manner. This guarantees that you will maximize your reimbursements. Time and accuracy make the difference between consistent and optimum reimbursement and resubmitted claims because of errors or lack of information. 

Coronis Health focuses on a high level of accuracy, which can easily increase your laboratory’s efficiency and reduce the amount of unpaid patient bills – resulting in maximum profit for your laboratory facility. When you weigh the options, it makes sense to go with a billing option that gives to your facility, and doesn’t take away from your bottom line. 

What to look for in a qualified billing service provider

Coronis is well-versed in medical and laboratory billing and coding. When you are researching medical billing companies, it’s important to understand laboratory billing is more complex than medical billing, as it focuses on a unique set of CPT codes, and the more experience a company has with laboratory billing, the better chance you have with increasing your revenue. 

Look for the following attributes of a billing company for your laboratory services:

• Specialized experience and expertise in laboratory billing
• What types of laboratories are serviced
• Clean claims and error rates
• Whether the company performs in-network and out-of-network billing
• What analytics or dashboards are provided for your review
• Available training and collaboration for your team
• Whether the company integrates with any LIS

How to reduce the administrative burden on your staff

If your lab is considering outsourcing, ask yourself: Is billing a core competency of our operation or can our resources be better utilized elsewhere?

Most labs agree that billing remains secondary to day-to-day specimen collections and testing. Maintaining billing within your facility creates more than just an administrative burden on your staff – it can increase overhead costs and time spend on hiring, recruiting, training, and developing a robust billing team. 

The cost to maintain a billing team includes more than just salaries – training and employee benefits are two big factors, but it’s necessary to also cross-training other employees to fill in if your billing team has absences or gaps in staffing due to turnover. 

Outsourcing your laboratory billing goes beyond maximizing your reimbursements; you will see an increase in job satisfaction, morale, and job stress that is created by the complex process of billing. 

Coronis Health has team members who only focus on laboratory billing, so your team can focus on everything else. The teams at Coronis Health are subject matter experts who have decades’ worth of experience specifically in laboratory billing. Many of the team members are former lab managers with high-level insight into the challenges that laboratories face. The team stays abreast on current and upcoming industry and regulatory changes to ensure your lab can address these shifts proactively rather than reactively.  Their expertise in billing and coding allows your team to set goals, organize, strategize, and focus on what matters the most – operating a laboratory. 

Questions about outsourcing your laboratory billing services? Contact Coronis Health today

If you want to eliminate staff turnover, increase your reimbursement, decrease your days in A/R, and reduce the cost of operating your laboratory facility, you are one step closer to maximizing your revenue and efficiency when you contact Coronis Health. When you call us today, you are making the decision to step away from the stress of in-house billing and partner with subject matter experts that can make the difference for your laboratory facility. 

from
https://www.coronishealth.com/blog/how-outsourcing-your-laboratory-billing-services-can-maximize-reimbursements/

Laboratory Billing and Coding Services: How They Can Help Your Facility

When it comes to clinical lab testing, you want the staff within your facility to focus on providing expert care and promoting optimal patient experiences. Tracking down revenue and dealing with insurance companies can feel like daunting tasks to healthcare workers, often leading to heavy workloads, drifts in focus, and high turnover rates. 

By outsourcing your facility’s laboratory billing and coding services, your staff can continue putting patient needs first while relying on a team of experts to handle your ongoing reimbursement needs. 

What Are Laboratory Billing and Coding Services?

Collecting on unpaid accounts should not be at the forefront of your staff’s responsibilities. Outsourcing your laboratory billing services allows your in-house team to make optimal patient care their primary goal. Billing services include selecting appropriate modifiers, billing patient insurance providers, and assuring timely receipt of payments. 

What Modifiers Are Used in Laboratory Coding?

Laboratory modifiers differ from codes used in standard healthcare billing, as determined by both Current Procedural Terminology (CPT) and the International Statistical Classification of Diseases and Related Health Problems (ICD). Outsourced billing and coding experts have the time, expertise, and resources to stay abreast of coding changes to establish a smooth billing process. 

Ensuring that the proper modifier is used can prevent claims from being denied by insurance companies. Laboratory coders work diligently by comparing services rendered to the patient’s benefits to verify coverage under their insurance premium. This attention to detail can hasten the reimbursement process, saving time and repeated paperwork while helping your facility’s billing department stay out of the red. 

The Benefits of Using a Professional Laboratory Billing and Coding Service Like Coronis Health

Facilities that outsource their medical laboratory billing services enjoy a long list of benefits, such as: 

• Maintaining focus on quality patient care
• Acquiring higher rates of reimbursement 
• Controlling costs and delinquencies
• Reducing revenue cycle management challenges
• Scaling down high operational costs
• Lowering staff turnover rates 
• Improving patient experiences 

How to Choose the Right Laboratory Billing and Coding Service for Your Needs

Selecting a third party to outsource your facility’s laboratory medical billing services should be a well-researched decision. You want to know that you’re choosing the best of the best so you can let the experts take the financial weight off of your staff’s shoulders. The provider you choose should:

• Employ certified, trusted advisors with decades of experience
• Utilize innovative technology to stay ahead of the industry
• Provide measurable results, transparency, and expertise
• Offer concierge-level service and attention at every turn
• Work with you to create a focused revenue cycle strategy
• Feel like a true partnership in your financial success

Tips for Getting the Most Out of Your Laboratory Billing and Coding Service

Once you select a competent, revenue-driven company to maintain your facility’s clinical laboratory billing for lab services, you can immediately enjoy the various added benefits outsourcing can provide. 

Relying on a team of professional billers and coders allows your staff to redirect their focus to providing the best patient care possible. By freeing up time they may have spent on adhering to proper HIPAA guidelines and dealing with insurance companies, your team of healthcare providers can put all of their energy into superior service. 

Not only does this change improve the balance of your staff’s daily tasks, but patients who receive individualized attention will also enjoy the benefits. An attentive and caring provider is a requirement of most patients and often leads to improved satisfaction rates and a loyal client base. 

By letting your healthcare staff focus on patients rather than laboratory billing and coding services, you can reduce the prevalence of employee burnout and high turnover rates. Instead, you can rely on the expert organization you entrusted to minimize billing errors and get outstanding accounts up to date.

While you focus on patients and allow your new outsourced partner to monitor your reimbursement rates, your facility will gain the financial benefits of cost savings and increased cash flow. By eliminating the overhead of maintaining an in-house billing and coding staff, your facility can use these funds to improve other areas of service. Relying on a team of professionals also ensures quicker collection rates and a more consistent cash flow as a result. 

Ready to Outsource Your Laboratory Billing and Coding Services? Contact Coronis Health Today!

The trusted advisors at Coronis Health Laboratory & Pathology provide specialized solutions to healthcare facilities by building a high-touch relationship with their clients. Coronis understands that staff retention, high-volume, low-dollar collections, and changing modalities can stretch labs thin and diminish their revenue. 

With 35+ years of revenue cycle management experience, Coronis Health Laboratory & Pathology has the skill, experience, and resources to maximize collections for labs.
If you’re interested in all the benefits your facility can gain by outsourcing your laboratory medical billing services, contact Coronis Health to request your free financial checkup today.

from
https://www.coronishealth.com/blog/laboratory-billing-and-coding-services-how-they-can-help-your-facility/

What is FQHC medical billing, and why is it important?

Federally qualified health centers (FHQCs) are federally funded health centers that provide medical care for historically underserved areas, ensuring everyone has the right to healthcare services. These facilities provide affordable access to primary and preventative care for patients and qualify for reimbursement through Medicare or Medicaid. 

FHQCs must meet several requirements for not only the services they provide but the way those services are reimbursed. FQHC medical billing can get complicated, as the medical coding rules and guidelines for Medicare and Medicaid are rigid and ever-changing. 

Let’s dive deeper into the nuances of FQHC billing and how it affects your center’s ability to reach its highest potential. 

What is FQHC medical billing and what services does it include?

Because FQHCs are federally funded, it’s important for medical billing and coding to be performed in compliance with the rules set by the Centers for Medicare and Medicaid (CMS) and the Health Resources and Services Administration (HRSA). The services performed at FHQCs must be carefully captured and billed so the facility can receive the necessary reimbursement and continue generating a healthy revenue cycle. 

An FQHC medical billing company does the hard work of medical billing and coding, adhering to the complex requirements involved. These are experienced billers and coders who understand the Medicare and Medicaid requirements—ensuring claims are clean, profits increase, and days in A/R decrease. Beyond FQHC medical billing service, some companies even provide revenue cycle management and financial reporting to identify and correct revenue cycle problems. 

How can FQHC medical billing help your clinic or practice run more efficiently and improve patient care?

Unfortunately, most health care teams don’t have the time and expertise to stay up-to-date with the ever-changing Medicare and Medicaid reimbursement requirements. The complicated nature of FQHC medical billing can lead to delays in financial reimbursement, financial errors, and overall team frustration. Accurate FQHC billing is crucial to yielding profits and creating a healthy revenue cycle. Abiding by the CMS and HRSA guidelines and avoiding denied claims allows for consistent net profit and more time to dedicate to patient care. 

The time-consuming nature of keeping up with the FQHC billing and coding guidelines can burden your staff. Many facilities handling the billing and coding in-house see poor collection rates and high claim denial rates, leading to lower staff morale, higher burnout, and less time for the most important aspect of your FHQC center—the patients. FQHC medical billing services relieve healthcare staff from the frustration of navigating the rules and regulations and puts the focus back on the patients. 

How does FQHC billing differ from traditional medical billing services?

FHQCs are reimbursed for their services on an all-inclusive model through Medicare and Medicaid. However, FQHCs often struggle to collect fair payment for their services, encountering higher claim denial rates and more lost revenue than traditional healthcare centers operating with commercial insurance. There are many unique aspects of FQHC billing, including:

• Sliding fee scales
• Cost-based reimbursement
• Encounter rates
• Wrap payments
• PPS Medicare reimbursement
• And more… 

All claims for services performed at an FQHC must also be documented with HCP and HCPCS coding that differs substantially between Medicare and Medicaid. These billing and coding differences are constantly changing as CMS releases updates. 

Due to the complicated nature of FQHC billing, it’s vital for FQHCs to closely analyze their revenue cycle and make changes that will support their growth plan. Lost revenue and high denial rates can stunt the growth of these centers, making it imperative to find the root cause of denials and correct them with experienced medical billers and coders to maximize their revenue cycle. 

Questions about FQHC medical billing? Contact us at Coronis Health today!

Coronis Health differs from a typical FQHC medical billing company by providing FQHC and CHC services for not only medical billing and coding, but collections and denial management, revenue cycle management, financial analysis, and reporting. 

We understand the importance of FQHC medical billing done right. Our highly trained, certified professionals will ensure timely financial reimbursements, an improved clean claims rate, and excellent customer service so you can put the focus back on patient care. 
Contact us today to learn more about what Coronis Health FQHC billing services can do for your team.

from
https://www.coronishealth.com/blog/what-is-fqhc-medical-billing-and-why-is-it-important/

Signs Your Facility Is Ready to Outsource EMS Medical Billing Services

As frontliners, your staff needs to focus on providing excellent urgent care. They simply don’t have the time or resources to keep an eye on collecting payments from insurers for EMS services. If it is becoming increasingly challenging to chase after payments while coping with frequent rule changes, it may be time to outsource your EMS medical billing services.

If you are still unsure whether you need to have a medical billing company on board, here are five signs to watch out for:

EMS Billing and Insurance Claim Processing Is Taking Time Away From Patient Care

The primary focus of any healthcare provider is patient care and satisfaction. When your staff are overworked and stressed, they will not deliver excellent, quality care to patients. 

If you notice that your facility is constantly handling EMS billing issues and chasing after patients more than providing healthcare, it may be the right time to bring in medical billing experts. While these professionals focus all of their attention on finding the best medical billing solutions to boost your revenue, you can devote all your time and energy to giving the best care your patients deserve.

Unable to Keep Up With an Increasing Number of Patient Billing Records

In many facilities, the staff has to spend an inordinate amount of time dealing with the large volume of patient records, resulting in billing and payment issues (in addition to disorganization and poor workflow).

Each provider also requires a different set of documentation and specific patient data when filing for claims. Having to manually manage countless files, records, and spreadsheets may cause duplications and errors. Any mistake, no matter how minor, can result in a denied claim. 

Partnering with a reputable medical company means gaining access to advanced technology that will help streamline your operations and workflow, track claim status, and improve your first-pass rate. 

Optimized search and retrieval tools can be seamlessly integrated into your existing office system. Existing documents, including billing-related paperwork, can be scanned and organized into a secure system and even accessed from mobile devices from anywhere in your facility. 

Not Enough Staff Members to Manage EMS Billing and Insurance Claims

Claim processing is integral to the lifeblood of any facility, and having a shortage of staff who can handle EMS billing services will inevitably lead to a slowdown in the processing of your claims.

When you outsource medical billing, you are hiring experts who will take over your claims review process. These experts don’t treat billing as a side project but as the core function of their job, guaranteeing that each and every claim will undergo a thorough process using the best billing practices to minimize error and increase faster reimbursements. 

Cost of Maintaining an In-House EMS Medical Billing Department Is Too High

Staff turnarounds are often high, and constantly hiring and training new employees can be time-consuming and costly.

Outsourcing EMS billing services can lead to financial savings because it eliminates fixed expenses, such as monthly salaries, payroll taxes, benefits to full-time employees, as well as purchasing technology systems. You also save time and resources when it comes to recruiting, training, and managing staff by having a team of experts handling all your billing needs.

Lacking Resources or Expertise to Manage EMS Billing Effectively

Taking care of patients leaves little time for paperwork tasks that need to be accomplished each day. More importantly, healthcare providers are trained to provide patient care and not handle administrative tasks such as billing.

With just a few employees on staff, your billing department can be overwhelmed with all the paperwork that needs to be processed. As a result, you can encounter data errors, denied claims, and delayed reimbursements.

The best EMS billing services provider is firmly rooted in and informed by the medical field. These experts are always in tune with what facilities need and provide their services in an efficient, intuitive, and comprehensive manner. In addition to experience, they have the flexibility to keep up with the latest industry trends and technologies.

Partnering with a medical billing and coding company will help simplify the overwhelming tasks for your facility, staff, and patients. The skills and experience of their team, coupled with advanced EMS billing software and processes, will take care of medical billing and coding while also staying in compliance with relevant privacy regulations. Your staff can then manage larger document loads, and patients appreciate the easy and rapid access to their records. 

Let Coronis Maximize Your EMS Billing Efficiency 

Coronis Health has extensive experience in the industry, specializing in the reimbursement and billing arena. Our team is made up of certified coders and industry veterans with expertise in cutting-edge billing technology, so you can be confident in knowing that we can provide the best EMS billing solutions and that your business is in the best of hands.

From customized monthly reports to certified coding services, we have the top-notch experience and technology to optimize EMS billing collections for providers, including fire EMS, private ambulance facilities, volunteer squads, and hospital-based ambulance systems. To learn more about how outsourcing your EMS billing services can help you collect more, improve the profitability of your facility, and focus on patient care, contact Coronis Health to request your free financial checkup.

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EMS Billing: What Your Facility Should Know

Are you understaffed to efficiently run field operations while keeping up with EMS billing functions? Is dealing with billing errors lowering your revenue? If so, outsourcing your billing services might be the best solution to relieve the pressure from your staff and optimize your cash flow.

What Is EMS Billing and What Services Does It Include?

EMS billing is the process of generating claims to submit to insurance companies for the purpose of obtaining payments for services rendered.

EMS provides 24/7 patient care in the form of first-line medical or emergency care for sick and injured people at the scene, whether in the person’s home or at an accident site, and while they are being transported to the hospital for care.

EMS services require a fee for any kind of medical assistance provided by paramedics, ambulance agencies, etc. These charges are typically covered by insurance premiums people pay, meaning that if a patient has health insurance, the service fee for medical assistance or transportation will be billed to insurance providers.

EMS billing services include:

• Comprehensive medical billing, coding, and collection services
• Credit balances processing
• Patient payment posting
• Charge entry
• A/R management and follow-up
• Credentialing and enrollment of providers
• Insurance verification
• Denial management
• Customizable Reporting

• Post Patient And Insurance Payments
• Provide Secondary And Tertiary Insurance Billing

How Do I Know If My Facility Needs EMS Billing Services?

Outsourcing EMS medical billing services not only addresses any organizational issues you may have in your billing department but also has a lasting impact on your bottom line.

These are the signs that it’s time to outsource EMS billing services:

• Administrative strain – If you are seeing inconsistencies in your revenue cycle, such as issues with your accounts receivable (A/R), timely filing, or an increase in denials, you may have staff who are struggling to keep up with the demands of the work.
• Frequently delayed payments – Denied claims are the number one reason for a delay in payments, and it could be related to several factors, such as overworked or inexperienced staff, which can result in a high rate of billing or coding errors or having to constantly train new clinicians or staff. 

• Diminished revenue – Compare your revenue with the industry median. If you fall below the industry average, outsourcing could be the key to optimizing your revenue.  
• Struggles with compliance – New policies and regulations are constantly introduced by the Centers for Medicare and Medicaid Services (CMS) and other third-party payers, so it’s critical to ensure that medical billers and coders are consistently updated on changes that affect the billing process. 
• Lower quality of patient care – A staff that is overworked and stressed may not be able to constantly deliver excellent, quality care to patients. Managing medical billing on top of their other tasks may reduce their ability to function at an optimal level.  
• A decline in clean claims percentage – If your facility has a clean claims rate lower than 85%, your revenue cycle management strategy is lacking. The percentage of your clean claims rate is a reflection of the work your staff is completing, so the lower your percentage, the more time your staff is spending on reviewing denials, communicating with payers, and fixing errors before submitting a claim for the second time. 

What Are the Benefits of Outsourcing EMS Billing?

These are the advantages you gain when you outsource EMS billing services:

• Lower costs – By outsourcing medical billing tasks, you can eliminate fixed expenses, such as monthly salaries, payroll taxes, and benefits to full-time employees, as well as save time and resources on recruiting, training, and managing staff.
• Fewer errors – Incorrect codes and patient data, duplicate billing, and authorization errors can be costly. Outsourcing medical billing allows you to partner with experienced, professional medical billers who utilize the most advanced EMS billing software to ensure that your claims are accurately submitted in a timely manner.
• Improved cash flow – Having a dedicated team for medical billing allows for a continuous, steady flow of clean claims going out and cash coming in. Increased efficiency – outsourcing EMS billing services will help streamline your operations and workflow. With more automated tasks, your staff can focus on their critical administrative functions and operational areas, resulting in enhanced productivity.
• Higher quality patient care – by allowing trained and experienced billers to handle all billing and coding requirements, you can free up more time to focus on patient care. 
• Compliance – keeping up with the ever-changing rules and regulations in healthcare can be a source of concern for many facilities. Outsourcing EMS billing services eliminates the headache of tracking these updates because the billing team stays on top of these changes and implements them into your processes right away. 

How Do I Choose an EMS Billing Service?

Here’s what to consider when selecting an EMS billing services provider:

Industry Experience and Expertise in EMS Billing

EMS billing requires a billing expert who can ensure each step is executed and managed correctly. A medical billing company with experience and expertise in EMS billing will have a better knowledge of your facility’s requirements for documentation, coding, compliance, and more. Failure to partner with a company that has expertise in EMS billing may result in coding inaccuracies and claim denials that make it more difficult for you to reach those bottom-line goals.

Security

Partnering with a medical billing company means trusting them with sensitive financial and patient data. Ask about their protection framework and make sure that the company will be able to handle all your data securely. 

Customer Service

High-quality customer support is crucial throughout the billing partnership. You want to ensure that your medical billing company is with quality customer support and helpful resources whenever you need them, enabling you to achieve peace of mind.

Claims Submission and Follow Up

Your billing partner should use the latest electronic medical billing techniques that will help your facility prioritize follow-up tasks, reduce the days spent in A/R, and boost collections. 

Transparency 

Medical billing services should include 24/7 access to all financial reports, which should be clear and comprehensive, allowing you to easily keep track of your facility’s financial health and make the best decisions for your business. 

Questions About EMS Billing? Contact an Expert at Coronis Health Today!

Coronis Health has extensive experience in the industry, specializing in the reimbursement and billing arena. We provide unparalleled efficiency to our customers when it comes to electronic medical billing and claims follow-up.

Our team is made up of certified coders and industry veterans with expertise in EMS billing and cutting-edge billing technology so that you can be confident in knowing that your business is in the best of hands.Outsourcing EMS billing is a great step to take toward achieving more efficient business operations and greater profitability. To learn more about how Coronis Health can help meet your specific needs and provide the best EMS billing solutions, contact us to request your free financial checkup.

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5 Revenue Optimization Tips for EMS Billing

Your facility can be an excellent provider of emergency medical services but still lose money to revenue cycle mismanagement –and you may not even realize it is happening. Adopting healthy practices is essential to ensure accurate and timely claims, reduce accounts receivables, and increase cash flow. 

Optimizing your revenue won’t just impact your bottom line. It also allows you to make work more manageable for your staff and payments easier for patients. Below are 5 tips on how to optimize your revenue. 

Learn Your EMS Billing Code Structure and Modifiers

Accurate claims submissions are only as good as the billing team handling them. Skilled and experienced billers understand how to review a PCR (patient care report) and accurately determine medical necessity and level of service. Any error may result in denials, delays, and increased accounts receivable.

All insurance providers, including Medicare and Medicaid, reimburse for ambulance and emergency services. However, this involves detailed documentation of unique codes and modifiers, including descriptions for modes of transport (ground, water, fixed-wing, or rotary-wing). 

EMS ambulance billing relies on recorded documentation. Healthcare providers should record correct clinical documentation during a case for reimbursement. Moreover, coding and billing are strictly based on this recorded documentation, so the documentation must be complete and accurate.

The CPT codes for ambulance transportation:

There are seven categories of ground ambulance services (both land and water transportation). These codes are based on the patient’s condition at the time of transport as well as services rendered.

A0425 – Ground mileage, per statute mile

A0426 – Ambulance service, (ALS), non-emergency transport (Level 1)

A0427 – ALS (Level 1), Emergency

A0428 – Basic Life Support, Non-Emergency

A0429 – Basic Life Support, Emergency

A0433 – Advanced life support, level 2 (ALS2)

A0434 – Specialty Care Transport (SCT)

Modifiers are two characters that represent origin and destination, and they are designed to show the origin first and the destination second:

Examples of modifiers for Ambulance Transportation

D – Diagnostic or therapeutic site excluded P or H when these are used as origin codes

E – Residential, domiciliary, custodial facility excluded 1819 facility

G – Hospital-based ESRD facility

H – Hospital

I – Site of transfer between modes

J – Freestanding ESRD facility

N – Skilled nursing facility

P – Physician’s office

R – Residence

S – Scene of accident or such acute event

X – Intermediate stop at physician’s office along the way to the hospital

Examples of second modifiers to be included after the origin and destination modifier. These can include but are not limited to:

CR – Related to a catastrophe or declared disaster

GA – ABN was required and obtained

GM – Multiple patient modes of transport

GW – Hospice patient, unrelated to the hospice diagnosis

GX – ABN was optional and obtained

GY – Service that is statutorily excluded

GZ – ABN was required but not obtained

QJ – Incarcerated patient

QL – Patient pronounced dead after ambulance called

QM – Under the arrangement

Use Technology to Improve Billing Accuracy and Efficiency

You may have team members doing highly repetitive tasks as a part of revenue cycle management, such as follow-ups on claim status, creating a patient statement, or verifying eligibility. Various technologies can easily be utilized to take these tasks and automate them, freeing up members of your team to focus on more complex and value-adding tasks. 

With digital tools at your disposal, you can simplify workflow and optimize timelier reimbursements while you avoid the inefficiencies and inaccuracies that are associated with manual paper processes. By leveraging technology such as EMS billing software, you will be able to automate your revenue cycle management processes, helping organize claims to maximize the efficiency of your staff while ensuring claims that need more attention get handled quickly.

Understand Your Local and State EMS Billing Regulations

Each state will have its own administrative codes and regulations that do more than set standards for urgent care. These regulations also set the requirements for licensure, certification, and recertification of ambulance suppliers, vehicles, and personnel to operate within the United States. 

Laws will also vary from state to state or within a state (for example, as stated by CMS, only in some jurisdictions is an EMT-Basic permitted to operate limited equipment onboard the vehicle, assist more qualified personnel in performing assessments and interventions, and establish a peripheral intravenous (IV) line. 

All these factors affect billing guidelines, and billers must ensure that the bill meets the standards of compliance. Billers typically must follow guidelines laid out by the Health Insurance Portability and Accountability Act (HIPAA), as well as their local and state requirements.

Submit Insurance Claims Accurately and on Time

The sooner a claim is submitted, the quicker you can get reimbursed by the insurance provider. One way to ensure quicker and more accurate claim submission is through technology.

Electronic claim submission is one digital tool you can rely on to facilitate the reimbursement process. Submitting claims electronically will help streamline your billing operations and increase cash flow. By filing claims electronically, you can:

• Increase accuracy and avoid claim rejections
• Track claim status
• Cut down on paperwork
• Decrease overhead costs
• Minimize disruptions to your cash flow

Consider Outsourcing Your EMS Billing Services

Partnering with an EMS billing services vendor is one of the best moves you can make to improve your revenue cycle management.

Outsourcing EMS medical billing services ensures you have certified professionals who engage in regulated, proven methods of obtaining prior authorizations, accurate charge capturing and coding, claim submission, denial and A/R management, and collection. The effective utilization of a revenue cycle team creates the centralization a healthcare facility needs to meet the challenges the industry presents with enormous amounts of data, changes, and regulations.

Medical billing and collections are critical to the survival and growth of any facility. A skilled medical biller is able to efficiently increase collections and reduce the revenue lost due to denials. In addition, a reputed medical billing company can also help reduce the burden of collections.

EMS billing is a complex process where anything can go wrong. From coding errors and processing delays to dealing with insurance companies and tracking unpaid patient accounts, your in-house billing staff has to juggle many tasks and also manage patient care.

Hiring a professional medical billing company can reduce many of these time-consuming tasks for you and your staff so you can focus more on patient care. The billing company will manage denials and appeals and use proven billing and collection strategies to reduce outstanding accounts receivables and optimize collection results.

Coronis Health Offers EMS Billing Solutions 

At Coronis Health, we recognize the need for your services and respect your roles as frontliners. While you are committed to saving lives, we are committed to protecting the resources that allow you to do what you do best.

Specifically, Coronis provides the following services:

• Customized billing services
• Delinquent accounts collection
• Follow-up procedures
• Staff training
• Audit services
• Patient services

We offer superior medical billing and technology innovation, integrating our services with your needs. We have 35+ years of experience to tailor EMS billing solutions and offer more than just medical billing. 

We go beyond your expectations with the latest technology, forward-thinking, and robust business intelligence. We grow with your processes and provide you with the services that maximize your revenue cycle management. 

We understand your needs, build trust, and gain a firm perspective of your facility’s goals, mission, and vision. Trust us to create a revenue cycle management team focused on your success.

Interested to learn more? Request your free financial checkup and find out why Coronis Health is the optimal choice for your healthcare facility. 

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What Is Revenue Cycle Management for Hospitals, and Why Is It Important?

Managing revenue is critical to the success of hospitals, as it ensures that cash flow is sufficient to pay for outgoing expenditures while sustaining the capacity to deliver high-quality patient care.

A healthy hospital revenue cycle management process helps ensure steady collections, timely revenue, and financial viability for your hospital, allowing you to focus on delivering excellent care to patients.

Unfortunately, many hospitals do not have access to the expertise necessary to maximize the RCM process. Below, we provide a hospital revenue cycle management overview, including the reasons why it is integral to healthcare. 

Hospital Revenue Cycle Management (RCM); Key Components

Revenue cycle management is a strategy hospitals and other healthcare providers use to manage administrative and clinical functions involved in the capture, management, and collection of patient service revenue.

The cycle begins as soon as a patient schedules an appointment up to the point that all of the patient’s payments have been collected, and there is a zero balance in their account. 

Steps in the revenue cycle management process include, but are not limited to:

• Pre-authorization and eligibility verification – a hospital collects information from the patient in order to establish a patient account. This step includes collecting insurance information and verifying their insurance eligibility.
• Charge capturing and coding – the process by which patient services are translated, transcribed, and documented into billable charges using universal medical codes, which allow insurers to determine reimbursement amounts.

• Claims submission – after coding, the claim is sent to the insurance company for approval. RCM keeps track of the claim to ensure it is processed quickly.
• Payment collections – once the claim is approved, the insurer reimburses the provider based on the patient’s eligibility. If after the insurance reimbursement there is any remaining balance, the hospital will be responsible for collecting the outstanding balance from the patient.

The Challenges Hospitals Face With Revenue Cycle Management

The following are the most common hospital revenue cycle management challenges that affect both cash flow and the quality of patient care:

Precise Coding and Accurate Billing 

Hospital medical coding and billing are vital to any hospital, and if done accurately and timely, can establish a smooth and successful revenue cycle.

Some of the billing and coding challenges that present themselves in hospitals include:

• Difficulty staying updated on new codes – specialties like Cardiology, Orthopedics, Pain Management, and Nephrology codes change continually, and it’s often difficult for hospitals to stay updated on the latest changes. 
• Failure to provide accurate and complete documentation – when documentation problems occur, it slows down your entire revenue cycle, leaves room for inconsistencies in coding, and decreases your billable expense reimbursements. Any documentation gaps for procedures can result in the loss of codable components and potential codes. Changes in a procedure can always occur, so it’s essential that providers provide thorough and complete documentation to coders. 
• Not coding to the highest degree of specificity – failure to code to the highest degree of specificity can result in lower reimbursement. Providers need to chart all relevant chronic and comorbid diseases completely. hen possible, providers should document the diagnosis, not just the symptom. The difference in diagnosis codes can impact the way care is graded or reimbursed, so coding to the highest degree of specificity has a direct impact on hospital revenue. 

Compliance Standards

A revenue cycle management system must uphold Healthcare Insurance Portability and Accountability Act (HIPAA) regulations to protect a patient’s personal information. Any form of healthcare fraud and abuse can result in penalties, which can negatively impact your hospital. You must always safeguard the privacy and confidentiality of protected health information (PHI) by complying with HIPPA’s mandated protocols.

HIPPA requires:

• Standardization of the medical codes
• A regular compliance audit of the facility
• Electronic filing of medical claims
• Foolproof workstations

Inefficiency in Exchange Information

Patient access management allows doctors to easily integrate data with the available records. However, exchanging information remains a challenge due to the complexity of health information with its many segments and nomenclature for various procedures.

Without the right interface ICT tools and strategies, it would be difficult to adopt standardized healthcare terminology and achieve interoperability, which is necessary to solve the data exchange problem between doctors, labs, hospitals, and pharmacies to a large extent.

Maintaining a Consistent Cash Flow

A consistent cash flow would translate to a fiscally healthy hospital. But if you have mounting rejected claims and have a slow A/R collection, you will need to find ways to increase collections and boost your cash flow.

Data Analytics

Data analytics plays a major role in healthcare delivery. It can organize and streamline health information, as well as optimize a clinician’s time and your revenue. However, most hospitals are slow in tapping the potential of utilizing consolidated data analytics in healthcare. They may be stuck relying on non-technical staff and inexperienced vendors.

Following-up with Payers

Around 10% of claims get rejected on the first attempt. If you do not have a skilled hospital revenue cycle management on board, your rejected claims will just continue to accumulate and consequently, impact your bottom line.

Patient-centered Care

Any physician must focus their time and effort on caring for their patients rather than managing the hospital’s revenue cycle. You need to provide quality patient care in order to keep your hospital running.

Why is Revenue Cycle Management Important for Hospitals?

With so many critical players and rules involved, coupled with the rapidly changing healthcare landscape, committing errors that result in lost revenue becomes increasingly probable.

Improving hospital revenue cycle management is an opportunity to streamline processes, automate tasks, and improve efficiency, enabling your processes to minimize errors that could potentially save millions in realized cash flow. Furthermore, a healthy RCM process gives you a competitive advantage by allowing you to provide the best patient care possible.

The Benefits of Outsourcing Revenue Cycle Management Services for Hospitals

Outsourcing revenue cycle management services provides hospitals with numerous benefits, including:

Optimized Workflow and Reduced Administrative Burden

Outsourcing RCM helps hospitals remain efficient and productive by having streamlined processes, from patient pre-registration to payment reminders. A hospital that runs like a well-oiled machine will not only ensure steady collections that make your organization financially viable but also lowers the administrative burden on your staff. 

An electronic workflow can help streamline all system facets, such as coordinating front and back communication, concluding a patient’s journey with timely payments, and eliminating lost paper documentation. This frees up more time for you to focus on delivering quality care.

Reduced Errors 

RCM services can assist hospitals to achieve a more efficient and accurate medical billing process. Having a team of expert billers results in reduced and timely detection of errors.

Faster Collections Process 

When your RCM services provider combines the right set of software solutions with automation tools, all the time-consuming tasks, such as data collection, insurance verification, and coding will take significantly less time compared to doing them manually.

By automating the cycle’s steps, from eligibility checks and payment follow-ups to data charge entry, you can expedite the entire process. When you streamline tasks, you become more efficient and effective as you provide a more straightforward system to your administrative staff and fellow physicians, resulting in faster collections and improved cash flow.

Better Claim Scrubbing for Fewer Denials

Denials are the result of payment claim errors. Optimized revenue cycle management brings accuracy to your facility’s system, leaving little room for mistakes. By getting coding right the first time, you get to reduce claim denials and receive your reimbursements faster. 

Improved Patient Experience

Skilled revenue cycle management professionals and the right technology will contribute to an efficient process that minimizes standard billing and coding errors. This means simplifying the process and improving all the touchpoints involved in the patient experience. 

Coronis Health is a global revenue cycle management company offering specialized solutions to healthcare practices and facilities. By using industry-leading technology combined with high-touch relationship building, Coronis Health allows healthcare practitioners to focus on patient care, maintain financial independence, and cultivate financial success.

Whether it’s collections, billing, denial management, or pre-registration authorization, our experienced group of collectors, billers, and healthcare professionals are ready to work with you as an extension of your current business environment. Attaining RCM improvements on your own can be a slow process. Overworked and under-trained staff, oftentimes, result in lower overall collection rates and shrinking margins.

Hospitals that have a forward-thinking approach to today’s hospital revenue cycle management and healthcare industry challenges give themselves a competitive advantage, and the extended solutions from Coronis allow hospitals to achieve that competitive advantage swiftly.

Are you ready to increase your revenue, reduce denials, and accelerate your cash flow? Contact Coronis Health to learn more about the importance of revenue cycle management in hospitals and how our decades of experience and data-driven solutions can help optimize your revenue cycle. You may also request your free financial checkup today.

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