Every hospital department deals with financial denials. Understanding the volumes of those denials for your outpatient therapy department can improve the net revenue of the department. A financial denial is when an insurance company or carrier refuses to pay for the healthcare services the individual receives. Within an outpatient therapy department, the level of denials […]
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In a previous blog post, we talked about how poor insurance verification and authorization processes can cause patients to either not come to therapy or to go to a competitor who can facilitate those processes faster. We know that notwithstanding patient choice, outpatient therapy providers should be able to offer an evaluation appointment within 3 […]
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Many outpatient therapy departments think of a no-show and cancellation reduction plan as a discharge plan. For example, if a patient does not show up a certain number of times, the organization may have a policy to discharge the patient. There is certainly a place for this for patients who repeatedly no-show and cancel. But […]
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Healthcare organizations need to pay attention to the amount of time it takes patients to get insurance verification and authorization completed. If the process takes too long, patients will seek treatment at other facilities even if they were referred to your organization. Insurance Verification and Authorization Benchmark Notwithstanding patient choice, outpatient therapy providers should be […]
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How would you like to reduce medical necessity denials in your outpatient therapy services? One way to do that is to ensure your therapists are capturing the impairment diagnoses in the plan of care. What is Impairment Diagnoses? Chapter 15 of the Medicare Benefit Policy Manual states: “a diagnosis (where allowed by state and local law) […]
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President Biden’s administration recently announced its Path Out of the Pandemic action plan which included specific guidance around a COVID-19 vaccine mandate. The action plan calls for employers with 100 or more employees to require employees to be vaccinated or submit to weekly tests, as well as requiring vaccinations for federal employees, contractors, and hospitals […]
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By John Britt, Senior Manager Outpatient therapy is a recurring service; for example, a routine plan of care is often 12 visits over 30 days. With rising co-pays and deductibles, patients are increasingly choosing less care, meaning less visits, than the therapists are recommending in the plan of care because of financial constraints. Your department […]
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When looking at your Outpatient Physical and Occupational Therapy departments, have you noticed a decrease in the volume of outpatient services? At Blue & Co. we often find that many hospitals and hospital systems have viable candidates for outpatient therapy services but are being seen by another healthcare organization due to a lack of a […]
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Outpatient Physical and Occupational Therapy are both paid either on a fee schedule or as a percent of charges. This means that if you are missing charges, you are missing out on net revenue opportunities. It is important to have an effective charge capture program to make sure your organization is not losing out on […]
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Staying Ahead of the CMS Auditor: Why Documentation in Outpatient Rehabilitation Matters The Center for Medicare & Medicaid Services (CMS) suspended audits between March and August of 2020 to allow providers to focus on providing care during COVID-19. But now external audits in outpatient rehabilitation are ramping back up. Since the Office of Inspector General […]
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The Centers for Medicare & Medicaid Services (CMS) operates within a budget neutral approach. This occurs at the same time the healthcare community continues to try and find balance between reducing administrative burdens, accurately recognizing and recording services provided, and upholding the highest quality care possible. Over the last three years, there have been significant […]
Carmel, Ind. (November 23, 2022) – The accounting and consulting firms of Alerding CPA Group (Indianapolis, Ind.) and Blue & Co., LLC (Carmel, Ind.) have announced their merger. The combined firm will operate as Blue & Co., LLC (Blue & Co.), effective December 1, 2022. This acquisition will provide Blue & Co. with greater market […]
By: Holly Fields, CPA, Senior Manager Not-for-profit organizations (NFPs) that receive federal financial assistance over certain levels, either directly from a federal agency or indirectly through state or local agencies, may be required to have a single audit performed under Federal Uniform Guidance. Single Audit Requirements A single audit includes not only an audit of […]
