Claims Processing
Analytics tools are increasingly being deployed across healthcare, but in few places are investments in those technologies more important than at small and rural hospitals.
The collections process is ripe for innovation, on both the payer and provider side. Increasingly, savvy providers are using health IT to broaden their access to and knowledge about their patient populations, with an eye toward greater success with bill collection.
A Mississippi health system and three hospitals in Texas, Indiana and Alabama are illustrating how hospitals can thrive, even in a tough economic environment. One hospital increased its revenue by $8.2 million after improving clinical documentation. Another changed the way it collected for services and boosted revenue by $6.1 million.
By mining state Medicaid data and utilizing a population health platform, the Wyoming Department of Health was able to slash its Medicaid-related emergency room visits by 20 percent in a one-year period.
The revised compliance date for providers, payers and clearinghouses to transition to ICD-10 has been finalized by the Department of Health and Human Services. It's Oct. 1, 2015 -- just 14 months from today.
Even if the ICD-10 compliance date is farther away than it once was, it will arrive eventually. (For real, this time. We think.) And while you'd be forgiven for taking a foot off the proverbial gas, this is time that should be spent pushing ahead with preparedness plans.
Simply put, most revenue cycle management systems aren't suited for a future where providers are paid for quality, not volume. That, coupled with increasing hospital consolidation and the fact that the "the average system out there is quite old," means the entire concept of RCM is due for a shakeup.
The long and short of it is this: Old code deteriorates over time. It begs to be transported to new platforms. With that, though, comes challenges.
Like most CIOs of three-hospital health systems, Karen Bowling has plenty keeping her busy these days. Now there's even more to do. With the mission of meeting a slew of federal mandates pretty much well in hand, it's time to help steer toward a future of accountable care.
Some physicians may end up paying nearly three times more for ICD-10 implementation than had been predicted just five years ago, according to a new report from the American Medical Association.