Revenue Cycle Strategist December 2019
The December 2019 issue of Revenue Cycle Strategist features articles on building a chargemaster, new coding changes for 2020, revenue integrity, evaluating and management charges and patient financing.
OPPS final rule keeps site-neutral payments and 340B cuts; finalizes transparency requirements separately
The controversial major hospital payment cuts in the Outpatient Prospective Payment System (OPPS) final rule were retained from the proposed rule even though hospitals successfully have challenged them in federal court.
E/M coding changes require education and technology updates
In 2021, major evaluation and management code changes will be implemented for new and established patient office visits.
5 new code changes focus on new medical technologies
The 2020 ICD-10 updates not as significant as expected but there are new codes for new medical devices and related procedures.
Defining revenue integrity KPIs
A strong revenue integrity program can help revenue cycle departments preserve the margins that further the mission of delivering high-quality healthcare.
Strategies for positive impact on revenue integrity
Revenue integrity requires proper staffing and bring activities to the front end of the revenue cycle.
How a 3-phase approach can rebuild your chargemaster
Review, analysis and revision are key components of a successful chargemaster review.
Long-term financing rises as top patient concern
An overwhelming majority of respondents to a survey patient payment experience say they need more than 12 months to repay their healthcare costs.
Analysis: CMS proposed rule could provide price data to inform physician referrals
While the proposed health plan price transparency rule will likely be challenged, if it survives those challenges, it will be far more impactful on health spending than the negotiated charge-posting requirement.
Getting to the root causes of denials
Root causes for denials should be defined operationally to determine the level of analysis required internally.