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Blog Posts by Tag: Compliance

Ensuring Oncology Practice Compliance with the No Surprises Act

The adverse impacts of surprise billing have garnered significant national attention, culminating in rare bi-partisan supported legislation that directly impacts community oncology practices. The No Surprises Act was signed into law as part of the Consolidated Appropriations Act of 2021.Surprise billing occurs when patients unknowingly receive either emergency or non-emergency care from an out-of...

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Five Steps to Capture Lost Revenue for Hospital Outreach and Outpatient Services | Part 4: Establish Universal Compliance in RCM

This blog post is part four of a five part series. View Part One, Part Two, Part Three. Running afoul of regulatory compliance requirements is a significant concern for hospital administrators and finance leaders—with good reason: the consequences can be steep. For example, in June 2020, a Georgia-based hospital system agreed to pay $16 million to settle multiple allegations of violating the...

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Digitizing Your Billing Helps Support the Planet

On April 22, 2021, the world celebrates Earth Day, an annual event to support environmental protection. The theme for Earth Day 2021 is Restore Our Earth, which is a call to take the necessary steps today to keep the planet healthy for tomorrow.At the same time, environmental, social, and governance (ESG) factors are an increasingly important part of an organization’s performance beyond the black...

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5 Strategies to Boost Your Revenue Cycle Profitability

In some hospital areas, such as outpatient, outreach, and ancillary service centers, revenue and profitability suffers when relying on electronic medical records (EMR) systems and enterprise RCM processes.Why? Using existing EMR technology when handling RCM activity associated with all claims can lead to high-volume, low-value claims being uncollected. Many finance executives see this method as...

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Effective Compliance Programs are Essential to Manage Risk While Driving Growth for IDTFs (Part 4 of 4)

In the final part of this four-part blog series, we focus on effective compliance programs for independent device testing facilities (IDTFs) revenue cycle management (RCM). If you missed the first three blog posts, you could find them here.Any review of the RCM process needs to include compliance considerations. Compliance requirements keep changing, and a misstep can result in lost revenues,...

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Time Is Running Out to Voice Concern over the SPA 20-0010 Amendment

Important: Public input on this controversial amendment must reach the DHCS no later than Monday, July 27, 2020, to guarantee consideration before SPA 20-0010 is submitted. See various ways to contact the DHCS at the end of this article. The Department of Health Care Services (DHCS) plans to submit its State Planned Amendment (SPA) 20-0010 to the Centers for Medicare & Medicaid Services (CMS...

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The Growing Importance of Revenue Integrity in Hospital Outreach

Revenue integrity continues to be a hot topic in healthcare, even as its exact definition is still being hashed out. Broadly, revenue integrity focuses on reducing compliance risk while ensuring optimal reimbursement. The National Association of Healthcare Revenue Integrity (NAHRI) dryly states the goal of RI is “to prevent recurrence of issues that can cause revenue leakage and/or compliance...

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Fighting Back Against Increased Claim Rejections Under ICD-10

The Dark Report recently reported that the implementation of ICD-10 diagnosis codes in 2015 has resulted in disrupted laboratory test billing and collections, rejected claims, and increased demands for medical-necessity documentation.Lab billing experts, including Kyle Fetter, Executive Vice President and General Manager of Diagnostic Services for XIFIN, said that alongside the new codes, payors...

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