Improvement and change can be difficult to incorporate into the daily operations of hospitals and physician practices. Factors such as decreases in reimbursement (due to Medicare and Medicaid funding cuts), increases in the uninsured population, declines in margins, and pressures from managed care organizations demand process improvements in the revenue cycle.
We can help achieve improved operational results by maximizing revenue and improving cash flow for your organization.
- Accounts receivable assessment and action plan
- Behavioral health coding and billing consulting
- Case mix analysis
- Coding reviews: MS-DRG, hospital outpatient, and
- Chargemaster reviews with education and training
- Chargemaster re-modeling and pricing
- Charge capture/clinical documentation
- HIM staffing and interim coding assistance
- Home health and hospice coding and billing consulting
- Implementation assistance
- Operational practice assessments
- Patient access optimization, centralized scheduling
- Practice management services
- Provider enrollment and credentialing
- Provider-based consulting
- Rural health clinic/FQHC consulting
- Specialty coding and billing education: cath lab, IR,
radiation therapy, etc.
- Supply/pharmacy revenue cycle management
- Telehealth consulting services
- Therapy operations and referral development
- 501(R) compliance
Blue & Co. has performed many Emergency Department Leveling Reviews for hospitals. The two most utilized leveling criteria are “points-based” or “intervention-based.” In either case, each hospital must determine which facility resources (or attributes) to include within its criteria, and how these resources crosswalk into ED visit levels (99281-99285). This can create significant reimbursement differences […]
In 2019 patient medical debt in the U.S. totaled at least $195 billion, according to an analysis by the Kaiser Family Foundation, a nonprofit organization focusing on national health issues. This is a massive figure and should be looked at as an opportunity for healthcare organizations. A survey conducted by Kaufman Hall in August 2020 […]
The Two Midnight rule, adopted in October 2013 by the Centers for Medicare and Medicaid Services, states that more highly reimbursed inpatient payment is appropriate if care is expected to last at least two midnights; otherwise, observation stays should be used. Original Two Midnight Rule In general, the original Two Midnight rule stated that, Payable […]
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