PMMC Healthcare Revenue Cycle Blog
Stay up to date on best practices for healthcare revenue cycle management with PMMC's blog.
It's Official: CMS Finalizes Mandatory Bundled Episodes Initiative
As expected, the Centers for Medicare & Medicaid Services (CMS) finalized the Comprehensive Care for Joint Replacement (CJR) model, which will hold hospitals accountable for the total quality of care they deliver to Medicare beneficiaries for hip and knee replacements from surgery through recovery. The announcement came in a news release on Monday.
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Price Transparency: Why Knowing and Defending Your Price Matters
There is a lot of discussion about Price Transparency in Healthcare across our country. Many state legislatures are getting involved, including Florida. Recently, Florida Governor Rick Scott announced he will encourage (some might say push) state legislation to require hospitals to post their prices for procedures and services as well as their average reimbursement on the hospitals' websites in early 2016.
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Florida Governor Not Backing Down on Price Transparency
Florida Governor Rick Scott is not backing down on his push for price transparency for health services.
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Are Florida Hospitals Price Gouging?
Florida Governor Rick Scott thinks so and he wants to add legislation to put an end to it.
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No More Surprises: Maximize Estimates to Educate Patients and Increase Collections
As patient responsibility continues to grow, point-of-service collections become increasingly important. According to a recent HFMA article, two-thirds of patients are consistently surprised by their bills and only 25 percent are proactively counseled about their cost of care. In response, hospital revenue cycle processes need to account for the shift in payment responsibility.
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The Alphabet Soup of the New CMS Bundled Episode Model
The Centers for Medicare and Medicaid Services (CMS) loves to use acronyms and there’s quite a few related to its new CCJR bundled episode payment model. For healthcare finance professionals, it’s easy to lose sight of some of these, so we’ll recap and break them down with definitions:
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Ready or Not, CMS says Go: Hospitals to Manage Episodes of Care
By now, most healthcare finance leaders are at least familiar with the recent CMS Comprehensive Care for Joint Replacement (CCJR) Model. This is a really big deal for healthcare providers. Let’s start with the basics:
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Why Can’t Patient Registration Be More Like the Airport?
Remember the days of waiting in line at the airport to actually have someone check you in at the counter? Those days are long gone in the airline industry, as airlines have adapted self-service kiosks, and more recently, mobile check-in to expedite the process even further. But this self-service model is still in the infancy stages in other industries, like healthcare.
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Strategic Pricing & Chargemaster
Steps for Planning a Chargemaster Review
Hospital pricing has come under intense scrutiny over the past several years, from both government legislation and media attention. The pinnacle of the media coverage came in 2013 when Time Magazine released “Bitter Pill: Why Medical Bills Are Killing Us.” The article highlighted the extreme cases of high prices at hospitals (i.e. patients getting charged $1.50 for single aspirin or $74 for a roll of gauze). Because of the recent pressure towards increased priced transparency and defensible pricing, hospitals are moving away from the traditional annual gross price increase.
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7 Tips to Maximize Reimbursement with Hospital Contract Management
The hospital contract management system is the key to maximizing financial performance, minimizing risk, and ultimately managing all aspects of payer contracts to get reimbursed accurately. However, it’s becoming more and more difficult to predict reimbursement. As third-party payers shift from a “fee-for-service” or “percent-of-charge” reimbursement model to value-based reimbursement, contract terms, coding, and their interpretations inevitably become more complex.
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