Code Encounters

Don’t wait too long to realize you need help with your Revenue Cycle. Too many providers ignore the warning signs of a poorly performing revenue cycle and are barely keeping their heads above water. Physicians and providers have a challenge as they rely heavily on others, typically to ensure that they are utilizing best practices and measuring key performance indicators to indicate healthy revenue cycle practices. Many don’t realize their reimbursements aren’t measuring up until it is too late. A good practice is to have an independent review/audit by an outside consultant at least annually and sometimes more frequently if you are experiencing poor financial performance. Consultants can not only identify gaps and lags in your revenue cycle but provide education to your current staff if needed. They can identify any revenue risk areas or areas of revenue loss.

Are you managing your denials appropriately and efficiently? Do you have a denial strategy? Have you identified a spike in denials? Here is what you need to know.

As many RHC providers can attest, it feels like they are the ugly stepchildren of CMS at times. Many Medicare benefits were not payable in the past to an RHC provider. CMS has implemented some needed changes effective January 1, 2022

OIG announced that they reviewed 100 telehealth claims performed in 2014 and 2015. Of the claims they found that 31 did not meet telehealth requirements.

President Trump signed and issued an Executive Order on Improving Rural and Telehealth Access that would expand the telehealth benefits permanently. Physician Fee Schedule Proposed Rule would make some telehealth and workforce flexibilities that were provided since the COVID-19 Public Health Emergency. It also focusing on improving access and convenience of care for Medicare beneficiaries, particularly those living in rural areas. One area the order also addresses is a multi- year effort to reduce clinician burden under Patients over Paperwork Initiative.

Telehealth flexibilities and waivers have been expanded - Here's what you need to know.