When seeking revenue cycle improvement, it is important healthcare organizations keep up with policy changes to avert denials, according to Crystal Ewing, manager of data integrity at Louisville, Ky.-based ZirMed.
Ms. Ewing shared the following tip with Becker's Hospital Review.
"Staying up-to-date with coding and medical policy changes can be challenging for providers. Bundling, unbundling, modifier usage, quantity limitations, and medical necessity are just a few of the many 'rules' that coding and billing specialist[s] must understand to avoid time-consuming and costly denials and appeals.
"By using data analytics to identify opportunities for improvement, providers can look at their denials in depth and determine if there are problems with their coding and billing — and more importantly why. The why is key to getting to the root cause and solving the problem. For example, the reason for the denial may identify specific areas that need improvement, such as medical necessity. With a robust data analytics platform that quickly and clearly makes denial data visible, providers can streamline improvements and see results faster — and faster results mean capturing more revenue."
Read more revenue cycle tips here.
If you would like to share your RCM best practices, please email Kelly Gooch at kgooch@beckershealthcare.com to be featured in the "RCM tip of the day" series.
More articles on healthcare finance:
7 hospitals with strong finances
Healthcare executives: Improving the patient experience is key to a healthy bottom line
Tenet shutters 4 regional management offices to cut costs