Starting a medical tourism business is not easy, but mounting changes and regulations in western healthcare systems have prompted a boom in medical tourism. In fact, according to a recent…
How does Fee for Service compare to Value Based Reimbursement
The cost of medical care has outpaced inflation for several years now, and it shows no signs of slowing. Despite skyrocketing costs, care quality is not improving under the traditional…
OIG Workplan 2019: What’s New!
We are entering the second year of the OIG’s new approach to publicizing and managing its FY18-19 Workplan. Just like last year, the OIG Workplan 2019 is not a static document. …
Understanding HIPAA Policies and Procedures
In 1996, Congress enacted the Health Insurance Portability and Accountability Act (HIPAA) primarily to protect individuals and their personal health information (PHI) contained in medical records. HIPAA applies to all…
Revenue Cycle Management Outsourcing
According to a recent Black Book Survey, revenue cycle management outsourcing stood at $11.7 billion at the close of 2017 and is expected to climb to $23 billion by 2023….
What is HIPAA Compliance? What You Don’t Know Can Cost You.
If you work in medical billing or healthcare administration, you probably think you can answer the question: What is HIPAA Compliance? Yet, a recent Office of Civil Rights (OCR) audit…
Healthcare Revenue Cycle Flowchart in 5 Steps
Healthcare revenue cycle management is a complex and complicated process that can drain resources when not properly managed. It takes considerable time and expertise to create and manage a well-maintained…
HIPAA Compliance Policy and Your EHR
As many organizations have found out the hard way, there is an important relationship between HIPAA compliance policy and your Electronic Medical Records (EHR). Consider these recent headlines: 100 million…
Value Based Care Reimbursement
A recent Black Book survey found that hospitals and other providers are gearing up to outsource key functions, including a move to outsource revenue cycle management to third-party vendors. Medical…
A Medical Billing Audit can Increase Profitability
A Medical billing audit is often thought of as a defensive measure. A government or private payor has denied or pended a series of claims. Now they want copies of…
HIPAA Requirements – and how to be in compliance
Many articles and blog posts mention HIPAA compliance, but what are HIPAA requirements, and what do you have to do to be compliant? What is the security rule? The privacy…
Strategic Planning in Healthcare – 12 Crucial Questions
Strategic planning in healthcare starts by measuring end goals against your current standing. It examines obstacles that sit between where your healthcare organization is and where it should be. When…
Physician Revenue Cycle Key Indicators of Best Practices
Physician revenue cycle operations continue to transform fundamental aspects of modern medical practice. The current unsustainable system drafts individual elements of the revenue cycle in search of success, often ignoring…
What is Value Based Reimbursement Looking Like in 2019?
Change is a constant in the healthcare industry, and for all healthcare providers submitting claims to Medicare it’s important to carefully review your processes based on what’s to come with…
Mayo Clinic handled this crisis of scrutiny through social media!
The Mayo Clinic was recently a target of inaccurate and incomplete reporting by CNN, and while debates of libel, freedom of speech, privacy, and contradictory information will most certainly continue,…
Hospital Revenue Cycle Best Practices for Profitability
Hospital revenue cycle management inefficiencies cost providers millions each year in lost income, and this is a single provider (and on average) estimate. When you examine hospitals collectively, this figure…
Healthcare Revenue Cycle Management Automation
Healthcare revenue cycle management needs to be automated! Revving up the revenue cycle or optimizing cash flow by cutting down on the time between patient-related services and monetary collections is…
Outsourced Chief Compliance Officer for Hospitals
For many healthcare organizations, especially smaller or rural hospitals, resources are scarce. Outsourcing can often be beneficial for hospitals. An effective approach in this situation is to outsource the management…
Value Based Reimbursement – Are you prepared?
Is value based reimbursement replacing Fee-for-Service (FFS)? FFS has been the standard in patient care for decades. The focus on revenue cycle best practices was and will continue to be…
Why Healthcare Organizations need a HIPAA GAP Analysis
A HIPAA gap analysis, according to the U.S. Department of Health and Human Services (HHS) is “typically a narrowed examination of a covered entity or business associate’s enterprise to assess…