Blog Posts by Tag: Radiology
6 Strategies to Support Patients and Optimize Revenue During the Medicaid Continuous Enrollment Unwinding
During the COVID Public Health Emergency period, the Medicaid Continuous Enrollment Provision was established; under this provision, Medicaid could not disenroll its members, even if they technically no longer met eligibility requirements. As a result, during the pandemic between 2020 and 2022, Medicaid enrollment increased by 25%. But the provision expired on March 31, 2023, and states have...
3 RCM Reports You Should Be Reviewing to Monitor Payor Payment Trends
Payor reimbursement behavior is complex and constantly changing. Payors make policy changes regularly and it’s challenging for medical providers to keep track of whether they are being reimbursed in full. Staying on top of payments whether for contracted or non-contracted reimbursements can require significant resources. Yet, if not monitored regularly, organizations will miss out on earned...
How Radiologists Can Maximize Their MIPS Scores by Documenting Performance
Under the traditional Merit-Based Incentive Payment System (MIPS), there are four weighted performance categories that contribute to your total MIPS score. For this blog, we’ll be taking a closer look at the Quality Performance category, which has an impact of between 30 – 85% on your total MIPS score, depending on your practice size and patient population. Meeting the requirements of the Quality...
Optimizing Billing and Cash Collection—Valuable Lessons Specialty Providers Can Learn from Clinical Laboratories
In our work at XiFin, we support a wide variety of medical providers, many of whom share similar challenges. While our founders and initial clients come from the laboratory space, we see an expanding need for flexible revenue cycle technology and services in other specialty and ancillary spaces. Specialty providers like radiologists, pathologists, anesthesiologists, remote patient monitoring...
Outsourcing Your Billing Processes: When does it make sense for outpatient diagnostic services?
From IT and EHR support to back-office functions, hospitals are increasingly turning to business process outsourcing (BPO) to relieve staffing and financial pressures. Within the hospital ecosystem – where technology and processes are typically optimized for high-acuity clinical encounters – outpatient and ancillary services departments can find it difficult to overcome their unique business...
The Link Between Patient Satisfaction, Billing, and Profitability
A patient’s billing experience is the last impression that influences their satisfaction with their medical care team. Even for diagnostic providers without direct patient contact, a dissatisfied patient can result in delayed payments, patient complaints, and loss of referrals. Satisfaction impacts the patient’s probability of returning to the provider and paying their medical bill. So, what can...
2023 MIPS – Examining How Pathology Scores Are Calculated
In the 2023 Quality Payment Program (QPP) final rule, there were minimal changes to the traditional Merit-Based Incentive Payment System (MIPS). The final rule focuses on further refining MIPS Value Pathways (MVPs) implementation. However, there are no pathology-related MVPs at this time. Therefore, the majority of pathologists will continue to participate under the traditional MIPS program.Two...
AUC Penalty Phase Delayed–Why Radiologists Need to Act Now, Not Later
The appropriate use criteria (AUC) program was established under The Protecting Access to Medicare Act (PAMA) of 2014 to ensure providers ordered the most appropriate advanced diagnostic imaging services for Medicare beneficiaries. Under the program, ordering providers will consult an electronic portal called a Clinical Decision Support Mechanism (CDSM) to ensure the established appropriate use...
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