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Regardless of whether your hospital has embraced the methodology associated with the term revenue cycle management, chances are youve heard the words bandied about.
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In October 2002, HCA in Nashville, TN, won an $8.8 million arbitration decision against Humana Medical Plan Inc. of Florida for the late payment or nonpayment of 3,300 patient accounts at 16 hospitals in Florida.
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The 2003 Physicians Current Procedural Terminology (CPT) code set released Dec. 31, 2002, contained over 500 additions, revisions, and deletions. Getting updated by April 1 is no easy task, but should be a priority, as mistakes could result in lost reimbursement, says coding expert Glenda Schuler, RHIT, CPC, CPC-H, senior health care consultant at Ingenix in Salt Lake City.
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Remote coders can be used to bridge the gap created by staffing shortages and fluctuating workloads, but its up to HIM managers to ensure that they follow the rules, says Betty Hatten, MHS, senior associate at PriceWaterhouseCoopers in Dallas.
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When considering opportunities to improve financial performance, benchmarking may not immediately come to mind, but health care managers who have used benchmarking techniques to enhance the fiscal well-being of their institutions have found it to be invaluable.
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The Outpatient Prospective Payment System (OPPS) implemented on Aug. 1, 2000, was a significant turning point for hospitals, moving them from a cost-based reimbursement to a CPT-4 and HCPCS level II line item prospective payment methodology, referred to as Ambulatory Payment Classifications (APCs).
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Cutting accounts receivables days from 116 to 43 is a monumental accomplishment. Cutting the days at the same time your gross revenue grows from $770,000 per year to $1.6 million per year without adding extra staff to the billing process may sound like a plot for a new unreality TV show, but it did happen at HomeReach Homecare in Worthington, OH.
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There is a growing fiscal crisis in state Medicaid programs. Those programs have increasing concerns about the fiscal burden of caring for elderly and chronically ill patients.
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