Business Intelligence – Why EHR Revenue Cycle Modules Aren’t Enough for Hospital Labs (Part 4)

  • Jun 14, 2019

As the final installment of this 4-part series, we’ll review the remaining two considerations for hospital and health system lab leaders when it comes to selecting the right RCM system for outreach and outpatient laboratory services. As discussed earlier in this series, too often health system leaders expect outreach laboratories to use the hospital’s enterprise revenue cycle management (...

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Improving Operational & Financial Performance – Why EHR Revenue Cycle Modules Aren’t Enough for Hospital Labs (Part 3)

  • Jun 12, 2019

As discussed in Part 1 and Part 2 of this 4-part series, hospital outreach and outpatient laboratories are often asked to use the hospital’s enterprise revenue cycle management (RCM) module that is offered as part of the EMR/EHR software in an attempt to save money or accelerate the return on investment on the enterprise software system. While this may seem like a smart, economical decision, it...

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Meeting Compliance Requirements – Why EHR Revenue Cycle Modules Aren’t Enough for Hospital Labs (Part 2)

  • Jun 7, 2019

As discussed in Part 1 of this 4-part series, too often we see hospital and health system leaders expecting outreach and outpatient laboratories to use the hospital’s enterprise revenue cycle management (RCM) module that is offered as part of the EMR/EHR software. While the health system may believe that the enterprise RCM system is the most cost-effective option, this fails to take into...

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PAMA Data Collection & Reporting – Why EHR Revenue Cycle Modules Aren’t Enough for Hospital Labs (Part 1)

  • Jun 4, 2019

Hospital and health system laboratories are under many of the same pressures as independent clinical laboratories. Compliance obligations and continued fee compression place a tremendous economic burden on many labs. While in the past, some hospital and health system leaders overlooked the economic value of the outreach lab, these leaders now recognize that outreach labs can add both strategic...

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Hidden Landmines in Revenue Cycle Management: Industry Challenges, Patient Engagement, and Denial Trends

  • May 31, 2019

A number of trends in payor behaviors and reimbursement go unnoticed due to outdated RCM management practices. Additionally, even known areas of reimbursement deficiency, such as medical necessity denials or increasing patient bad debt, can be easily neglected due to lack of resources or knowledge of an effective resolution.During the 2019 Executive War College in New Orleans, I presented on the...

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Key Themes from the Precision Medicine Institute Symposium

  • May 30, 2019

Earlier this month I attended the Precision Medicine Institute Symposium 2019 in New Orleans where I had the privilege of presenting Precision Medicine Informatics: What Hospitals, Physicians, and Payers Need to Know about Challenges, Approaches, and Best Practices. The one and a half day symposium organized by the Dark Intelligence Group provided an opportunity for trailblazers in the...

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New Study Demonstrates GAO’s PAMA Report Based on Faulty Assumptions

  • May 22, 2019

In a XIFIN blog post from April 5, we address that the Government Accountability Office (GAO) report entitled, “Medicare Laboratory Tests Implementation of New Rates May Lead to Billions in Excess Payments” appears to demonstrate a misunderstanding of how price and panel bundling work in laboratory billing and reimbursement.The report appears to suggest that American Medical Association (AMA)...

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The First Steps in Preparing for the PAMA Reporting Period (Part 1)

  • May 15, 2019

Solid reporting from all applicable laboratories is the key to mitigate future PAMA fee schedule cuts. This means labs need to be able to report on actual allowables vs. payments, validate the accuracy of payments, and optimize appeals activity to avoid under-reporting payments. All applicable labs are included in the current data collection period now underway for the first half of 2019.Step 1:...

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