Posted on Wednesday, June 14, 2017 7:58 PM
Denials are only a symptom of possible breaks in the process downstream that result in delayed or loss of revenue for home health and hospice providers. The health care revenue cycle is complex and everyone, clinical and administrative, plays an important role. Let’s face it, we don’t do a very good job educating clinical staff about their part or building collaborative teams to examine those small but crucial steps that may result in non-payment. Every claim sitting on accounts receivable beyond the expected adjudication date is the result of some gap in process, training, technology and analytics.
So how do you plug the holes in the leaky bucket?
· Start with the data and dive deep. Understand your current metrics and adopt benchmarks and standards for your revenue cycle. Review for continuous improvement on a regular basis. Utilize available technology, such as all payor eligibility systems, clearinghouses and the full functionality of your EMR. Develop process improvement teams to address the problems and give them the backing they need to move towards resolution.
· Start asking questions. Why has this claim been on the AR for over 120 days? Why didn’t something get the correct authorization? Why do we keep entering patients with Medicare Advantage as Medicare (and miss the opportunity to get authorization)? If we had checked eligibility correctly would we have identified this issue? Does everyone in the process have the education and training they need?
· Or buy a new bucket. Let Corridor help with thirty years of RCM experience and our proprietary CashAssure® system.
Click here to learn more about Corridor’s RCM solutions for Home Health and Hospice.
Click here to read more about how one provider got their AR under control.
Written by Robbin Boyatt M.P.H., Corridor’s Vice President of Revenue Management Services.
About Corridor
Corridor is the nation’s preferred partner and trusted business advisor to home health and hospice providers, providing quality services and impactful results for 30 years. Focusing on key operational, regulatory and financial challenges, Corridor delivering industry-unique solutions and deep expertise in coding, clinical documentation review, compliance, billing and collections , consulting and provider staff education . At Corridor, we make the business of caring for people Better! For the most important industry updates and news that impacts home health and hospice, please make sure to sign up for our weekly newsletter to receive the latest up-to-date industry information direct to your inbox!
For additional information, please contact Corridor at 1-866-263-3795.
