Tuesday, December 27, 2016
Thursday, December 22, 2016
Wednesday, December 14, 2016
Saturday, December 10, 2016
There is a new development within the Affordable Care Act Marketplace and those who have yet to get on board the system should take this as the perfect opportunity to do so. Healthcare facilities can help their patients prepare for the marketplace first of all by ensuring that they are given the right information about what to expect, what the new requirements are and what are the notable deadlines that they should pay attention to.
For the upcoming 2017 coverage, individuals may sign up for an open enrollment beginning November 1st of 2016.
2017 Enrollment Calendar
This registration will continue until the 31st of January in 2017. However, those who want to get covered as soon as Day 1 of the new year hits should get enrolled by December 15th. The blog article originally appeared on DECORM.com blog page.
Friday, December 9, 2016
A recent study reveals that there has been a steady increase in the numbers of children beneficiaries for disability social security. The Supplemental Security Income (SSI) program is the one responsible for extending financial assistance to disabled individuals who also have limited resources.
According to the study, there had been an increase of as much as 1.8 percent in the number of children who received SSI benefits from the years 2004 to 2013. Among the identified contributing factors for this increase in recipients are 10 major mental disorders, such as depression, bipolar disorder, attention deficit hyperactivity disorder (ADHD), intellectual disability and autism spectrum disorder. Head on over to DECORM.com blog page to know more.
Thursday, December 8, 2016
The application of Medicaid has greatly evolved throughout the years, and with it, the systems that govern it for efficacy. Despite it being in place for a good while now, there are still a lot of people who remain uncertain about their eligibility for Medicaid. Medicaid Expansion by State The first thing that patients should know is whether or not they are covered by the expansion of Medicaid. Not all states have adopted the expansion policy and so, there may be particular items that may not apply in case the state does not recognize it. Specifically, this pertains to the coverage of all households that fail to meet a certain income bracket. It used to be that a person’s Medicaid eligibility depended on their household size vis-a-vis their income, family status and disability among others. These are well-established tenets of Medicaid across all states. Read more on this article.
Wednesday, December 7, 2016
The administrative aspect of running a hospital is otherwise known as revenue cycle management services. Without an organized and healthy system in place, the coordination among the different teams in the organization, from the doctors to the nurses, and even up to the administrative staff, are affected. Revising Data Collection The very first step in revenue cycle management is data collection. Setting up the profile of the patient should give the administration a clearer picture of the kind of approach they should have with the patient and their transactions. Various institutions are studying and looking into certain modifications to the payment terms indicated in the contracts, whether for insurance coverage, co-pay or self-pay. Modifications might also be implemented with data collection, which could possibly help further improve revenue yield, especially since the implementation of the new Medicaid expansion program. Read more from this blog.
Monday, December 5, 2016
Thursday, November 17, 2016
Friday, November 11, 2016
Monday, November 7, 2016
Thursday, November 3, 2016
Tuesday, November 1, 2016
The Affordable Care Act Marketplace (ACA) has the primary goal of making high-quality healthcare attainable for everybody, regardless of their current health condition and financial status. Also called the new health insurance marketplace, this is a means by which patients can explore the packages available for them, finding the best plans that fit their needs and their budget.
Health Care Plans
As mandated by law, health care plans should cover the 10 essential benefits for patients. Prior to this law’s enactment, certain health insurance providers vary the packages available as a means of limiting the benefits that their client’s receive.
As in previous years, there were non-inclusions and fine prints in many health plans, making it a challenge for patients to really get the treatments they need. If they wanted to get more coverage, they were expected to pay more. Such is not the case when it comes to the ACA. Read more on this article:
Sunday, October 30, 2016
If you are caring for a patient that has a disability, Social Security may give assistance in covering for living and medical expenses. You may extend your services to your patient by talking him or her through the application procedure. To know what to expect throughout the process, it helps to identify certain points involving disability benefits and rules.
Qualifications for Social Security Disability
By definition, the Social Security Administration (SSA) says that a disability is a condition that prevents an individual from performing gainful activity. Any attempt to perform such activities may cause physical or mental impairment to the person. The disability should have also persisted for a period of not less than 12 months, according to sources. Read more on this article:
Friday, October 28, 2016
In the healthcare industry, the role of a clinic or hospital encompasses beyond just giving medical treatment. An added service that can be offered to patients is to help them apply for Medicaid. With proper guidance from doctors, nurses and other hospital staff, patients can determine their eligibility for Medicaid and have a better chance of receiving the benefits they deserve.
Medicaid and Revenues
Research has found that hospitals with a mix of patients with Medicaid and other private healthcare plans are more successful in getting collections. This is an improvement compared to hospitals or clinics who serve only self-paying patients or privately-insured clients. Data suggests that with the right healthcare revenue cycle management strategies and with proper monitoring, hospitals can expect profits, even if they have many patients under the Medicaid program. Read more on this article:
Wednesday, October 26, 2016
For a hospital to continue providing quality healthcare for its patients, it needs to make profits, and these earnings are dependent on the revenue cycle. The revenue cycle involves several processes, from the time a patient comes in to get treatment, up to the time he is billed, and until he or his insurance provider makes payment for such services.
There are instances, however, wherein a hospital faces challenges when it comes to revenue, further stressing the need for decisive action on the part of the management.
Errors in Data Gathering
Revenue cycle management often involves pinpointing the cause of lost revenue or potential debt in a hospital. At times, this happens when front line staff make errors when interviewing patients as soon as they enter the facility. They make mistakes in inputting the correct data about a patient’s personal info, contact details, his condition and meds, and others. Read more on this article:
Friday, October 14, 2016
Tuesday, October 11, 2016
Friday, October 7, 2016
Tuesday, October 4, 2016
Monday, October 3, 2016
Also labeled Obamacare, the Affordable Care Act (ACA) has greatly influenced the healthcare system because of its incumbent changes to insurance policies and coverage. New health insurance marketplace coverage options affect hospitals, doctors and insurers in different ways. Understanding this impact is necessary for hospitals to improve their operations and customer service.
The quality of care is now gaining more attention because the ACA can halt Medicare payments to hospitals if too many patients return with complications within a month. This is why hospitals are keener on ensuring that patients receive optimal care, even after they are discharged. Some facilities even send nurses to the patient’s home to ensure that they are taking their medicines and following the doctor’s prescription. Patients are also monitored and encouraged to schedule a follow-up examination.
Sunday, October 2, 2016
Every hospital should be committed to helping patients get the best service and treatment; they can do this by understanding all avenues wherein assistance is available. Social security disability for children is one these avenues. However, many parents don’t know how to acquire this for their children.
Here is where hospitals come in. They can guide parents throughout the process by learning the basic ways in which parents can join the program.
There are three types of children who can benefit from disability social security:
Low-Income Disabled Children
If the child comes from a low-income household, they can be eligible for Supplemental Security Income (SSI). This assistance can last until they reach the age of 18, but they can continue receiving assistance through adult SSI benefits. Medicaid is also available to children approved for SSI disability.
Saturday, October 1, 2016
Processing health insurance claims of patients in an efficient manner positively impacts your hospital revenue cycle management. Think of it this way: The more insured patients you treat, the greater your revenue rises. Given this, it’s essential that your RCM focuses on determining and verifying insurance eligibility, which is part of the initial phase of every transaction.
Determining patients’ eligibility for Medicaid and other health insurance programs takes time and requires a set of skills and knowledge. The staff performing this job should be well aware of all aspects of Medicaid enrollment, a daunting task to say the least.
This is why many hospitals struggle with this area of their RCM. If this is the case for you, then you may want to start seeking third-party help to deal with all Medicaid eligibility requirements. Doing so reaps many benefits, especially if your workforce is too light for such a job.
Friday, September 30, 2016
Because revenue cycle management has undergone changes and adjustments with arrival of the Affordable Care Act (ACA), hospitals need to constantly adapt. They must deal with financial pressures stemming for the act to ensure that the facility’s revenue cycle continues to be efficient.
There are several challenges that hospitals may face, prompting them to consider hiring a firm that specializes in enhancing elements that drive revenue cycle management services.
Mistakes in Billing and Collections
Because patients are becoming more acclimated to settling out-of-pocket costs, hospitals may have a hard time collecting all revenues paid at point of service. Their billing process must be improved in a way that allows the staff to collect all payments without unduly pressuring patients.
Monday, September 26, 2016
Wednesday, September 21, 2016
Saturday, September 17, 2016
For disabled patients, Medicaid and Medicare are extremely important for dealing with medical conditions or mental disabilities. As a hospital, you can help patients receive these awards by taking these measures.
Monday, September 12, 2016
Sunday, September 11, 2016
Since the Affordable Care Act (ACA) became law in 2010, the number of uninsured Americans has sharply dropped. According to data from the Centers for Disease Control and Prevention (CDC), fewer than 1 in 10 citizens were uninsured in 2015, the lowest number ever in the country’s history.
That said, it’s not just everyday people who were spared from the financial strain that illnesses caused. The Affordable Care Act marketplace helped bolster the bottom lines of hospitals as well. With more people medically insured, healthcare providers encountered fewer unpaid medical bills, the bane of their revenue cycle management.
With the landmark law now in its sixth year, there are numerous developments of which hospitals need to stay abreast. The more they know about these trends, the more able they are to continue reaping the benefits of the Affordable Care Act.
Saturday, September 10, 2016
Treating patients is hard work, but even more so when dealing with disabled children. Whether congenital or acquired through injuries, a disability requires specialized care and closer medical attention than most other patient cases. Furthermore, while some disabilities can be rehabilitated over time, others--such as mental impairments--remain for life.
Child disabilities are not a rarity in the country. According to the U.S. Census Bureau, there are about 2.8 million school-age kids with disabilities. As expected, caring for a disabled child can be financially taxing. Advocacy group, Autism Speaks, reports that the cost of caring for a person with autism is around $2.3 million over the course of a lifetime--a huge burden for parents and other family members.
Friday, September 9, 2016
The Kaiser Family Foundation has diligently tracked public opinion of the Affordable Care Act (ACA) since it passed into law in 2010. Six years later, most Americans still dislike the law, with 46% opposed to it and 40% for it.
The proposed expanded eligibility for Medicaid especially irks opponents. Critics say such a move will present a costly burden to states that implement expansion. If you operate a health facility, no doubt you’ve heard that expanded coverage will overwhelm hospitals with an influx of patients. The reasoning seems sound: With more people covered by medical insurance, more patients will flock to healthcare facilities.
Thursday, September 8, 2016
It won’t be an instantaneous change, but the days of fee-for-service healthcare are coming to an end. If you run a medical facility, you’ve undoubtedly heard about the value-based care model, in which hospitals will receive incentives for providing excellent patient care. Reduction in repeat visits will be one of the key metrics.
This paradigm shift, promulgated by insurers who are aggressively reducing reimbursements to healthcare providers, is forcing many providers to abandon the fee-for-service approach in favor of value-based care. This model maintains that the fewer times a patient returns to a doctor, the better the medical care received, resulting in lower healthcare costs for all involved.
On the flipside, hospitals unable to help patients achieve lasting and measurable health improvements can face steep penalties. Therefore, merely hiring revenue cycle management companies no longer suffices.
Tuesday, September 6, 2016
Tuesday, August 23, 2016
Speed Up Their Claims Process
Getting social security disability can take a long time, so you need to do everything possible to speed up the claims process for your patients. You can do this in many ways, such as submitting the medical records yourself.
Thursday, August 18, 2016
Wednesday, August 10, 2016
Providing Medical Evidence
For patients to get these benefits, they need to show that they are indeed disabled. You need to tell patients how they can do this, which includes making a list of the hospitals and doctors that they have consulted with. If it is your hospital, make sure to communicate with the doctor they have been seeing, and ensure that he can provide the pertinent medical records.
Friday, August 5, 2016
To make the process simpler, you should provide patients with a chart that breaks down the different types of health insurance. Some of these include HMO, PPO, EPO, and POS. Some plans let you choose the doctor while others require you to use an accredited specialist.
Thursday, August 4, 2016
Gone are the days when individuals from a specific income bracket worry about hospital bills and basic health necessities as they cannot afford to pay for a premium of health insurance yet, are still not qualified for a Medicaid coverage. The affordable care act marketplace has introduced new ways in which these same individuals can pay for quality health care without adversely affecting their finances.
Aside from the Medicaid expansion, ACA’s new health insurance marketplace coverage options have made it feasible for every individual residing below the federal poverty line to afford various healthcare services – a feat that has never been possible before.
Wednesday, August 3, 2016
Healthcare in today’s America has become more accessible, thanks largely to the laws passed these past few years to make it all possible. Nowadays, health services are not only available to those who are able to pay high premium insurances but also to those that come from low income families and those who are suffering all kinds of debilitating physical disabilities.
However, not everybody is aware that they are eligible to get social security disability from the government, if the need arises. In fact, it seems like most Americans don’t know much about this program, as they firmly believe that disability is a situation that can only happen to somebody else.
Tuesday, August 2, 2016
With the signing of the Affordable Care Act (ACA), more commonly known as Obamacare, some states have invariably adapted the expansion of Medicaid to accommodate more people and provide a quality healthcare services. This means that the eligibility for Medicaid, for some, has become a lot easier, especially for those whose yearly income falls under the coverage gap.
The Paradox of Medicaid Expansion
The Medicaid expansion has been both lauded and criticized by opposing parties who are still arguing on the possible effects the ACA on the business of healthcare services. On one hand, the increasing number of those who visit hospitals and other various healthcare providers can only spell a better hospital revenue cycle management for the facilities located in states that adopted the Medicaid expansion.
Monday, August 1, 2016
The Affordable Care Act (ACA) had its share of difficulties and controversies from the time it was proposed up until the time it was signed and enacted by the Obama administration. But, as the time for President Barack Obama to step down looms closer, the fate of ACA becomes vaguer, with analysts expecting that certain provisions under this law will come under intense debate once again.
In the middle, healthcare providers are caught in a limbo, with many of them asking, “What is revenue cycle management in the face of this incoming political change?”
The ACA and its effects on the revenue cycle management
The ACA’s objectives are to: increase affordability of health insurance, lower the number of people uninsured and reduce the overall costs of healthcare without sacrificing its quality.
Monday, July 18, 2016
Wednesday, July 13, 2016
Sunday, July 10, 2016
The ObamaCare had a very controversial start, but five years on and it’s proving to be the positive change that it was purported to be. Adjustments are still being made, though, and there is certainly more room for improvements for healthcare facilities and their revenue cycle management systems.
With this new policy, also comes new health insurance marketplace coverage options, which should prove to be a lot of help for the ObamaCare benefactors. On the part of the companies, meanwhile, the adjustment would be crucial in delivering a smooth transition of filed documents and records pertaining to their clients and patient, especially those who are classified as self-pay patients who pay outside of the mechanisms of an insurance policy. In its stead, however, is the available option for ACA enrollment.
On June 1, 2016, President Barack Obama called for the further expansion of the Social Security program, particularly to support retirees. Saying that “fewer and fewer people have pensions they can really count on,” Obama said that officials should work for the program’s greater “long-term health” and make it more “generous” for “today’s retirees and future generations.” He then suggested that bigger tax contributions from higher-income Americans – including himself – could make this expansion possible.
Government welfare, particularly in healthcare, has been one of the most contentious issues in the outgoing President’s tenure. Obama’s statements figure to be a “game-changer” in the race to replace him, says Michael Hiltzik of the Los Angeles Times.
The Center for Medicaid and CHIP Services (CMCS) announced on June 1, 2016 that Medicaid funds can now be used to help combat the Zika virus. This virus, transmitted through the bite of infected mosquitoes, causes fever, rashes and joint pain in adults. It is rarely a cause of death, but has serious health consequences on pregnant women and their unborn.
In a five-page bulletin, the CMCS describes how individuals with eligibility for Medicaid can protect themselves from the virus, undergo tests to see if they have contracted it and receive treatment in case they do.
Thursday, July 7, 2016
Wednesday, July 6, 2016
In all of this, it’s fairly easy to understand how the staff can be inundated with administrative tasks on top of their medical duties. What is revenue cycle management further contributing to this status quo is a lot more complication that can very well affect the operations of the facility as a whole. This is why alternative options exist, such as, supporting agencies that can provide assistance to the facility for this particular task.
Friday, July 1, 2016
Wednesday, June 8, 2016
Monday, June 6, 2016
Friday, June 3, 2016
Wednesday, June 1, 2016
Sunday, May 1, 2016
Having health insurance these days can be just as frustrating as being uninsured. From finding a doctor that will accept your specific insurance to hoping that the majority of your medical bills will be covered, expect to be confused and lost. Health insurance is supposed to cover the cost of medical expenses, depending on the plan that is chosen and premiums that are paid. There are many situations, however, where the insurance company does not reimburse the doctor simply because the ""diagnoses"" are not covered. This is when the patient receives that dreaded bill from the doctors' office and asks if there are better coverage options available.
Saturday, April 30, 2016
From the annual MRI that follows the patient's disease progression to the costly preventive medication, multiple sclerosis is one of the most expensive diseases known to man and yet, it is also one of the most difficult to to be approved for when filing for disability social security. Because this disease causes a bevy of symptoms and possible long term disabilities, MS patients often find themselves in limbo with their medical treatments. Even when a patient is not permanently disabled, short term disability can become a very valid issue, causing missed time away from work, resulting in even less money for expensive medical bills.
Friday, April 29, 2016
According to Medicaid.gov, the Affordable Care Act of 2010 expands Medicaid benefits to millions of Americans. Under this law, individuals can qualify for benefits if they meet specific federal poverty guidelines. You qualify if your income is 133% below the federal poverty level. Keep in mind that states have different qualifications and some states are not expanding Medicaid. The eligibility for Medicaid will vary and is based on your personal circumstances. Moreover, you can meet Medicaid eligibility requirements based on your family status, income, family size, disability and other factors. You should apply for Medicaid if your state has not expanded its Medicaid program. Hospitals are using revenue cycle management systems to help individuals qualify for Medicaid and other healthcare plans.
Wednesday, April 27, 2016
Some patients that are cared for in your medical center facility will pay cash on the spot at the time services are rendered. Others may have insurance that will pay for most services, and the patients may pay their co-pay immediately. Still others, however, will have large bills that need to be collected, and they will not have the immediate means to do so. It can be costly for your hospital to pay for services that are uncollected, and review cycle management services are available to assist in improving the collections process.
One of the provisions in the ObamaCare Act, more formally known as the Affordable Care Act, is the establishment of a marketplace where applicants can get insurance information as well as multiple quotations and seamlessly enroll all on one go. Aside from insurance options, the platform is also a good place to head to if you are looking for information on eligibility for coverages as well as tips on how to lower costs involved in health care. Not many people may know it but there are actually three types of Affordable Care Act marketplace – the federally sponsored marketplace, joint or partnership-run, and the state-based marketplace. This marketplace is oftentimes also referred to as Health Insurance marketplaces and health insurance exchanges. The main difference between the two is typically the qualifications but the process of applying is still the same, and can be done at HealthCare.gov.
Tuesday, April 26, 2016
In any business, there would be always that one client who can be slow when it comes to settling their invoices. Although this can present a huge headache for you, there is actually a way to deal with it. In the hospital and healthcare industry, such way of dealing with ensuring the proper collection of payments is known as Revenue Cycle Management. RCM in Hospitals and the Impact of Incorrect Information The revenue cycle in hospitals typically start as soon as the patient steps in, and ends with them paying the bill. There are cases, however, when the settling of payment can be quite complicated. One good example of this would be when the information encoded in the system is erroneous and the hospital has to take into consideration healthcare benefits such as disability social security. Fortunately, there is a way to deal with this - skip tracing.
Monday, April 25, 2016
Within the medical field, revenue cycle management is defined as the processes and procedures related to the capture and management of revenue. While this might seem sound like a very simple and straightforward procedure, that is not actually the case. In fact, if the revenue cycle management in place is not well planned, it could cause more headache for the medical service providers. You have to remember that revenue cycle management starts from the time the client steps into the medical provider’s office and ends when he or she has finished with the procedure and have settled all current bills. That being the case, you need to make sure that you know how to choose the right service provider for your medical business.
Sunday, April 24, 2016
The medical field may be about helping people but, you have to keep in mind that, it is still a business. That being the case, hospital owners would also need to keep a sharp eye on their revenue cycle management. Fortunately, there are a number of ways by which this can be done, and more. Importance of A Good Revenue Cycle Management System Revenue cycle management companies would tell you that a good collections practice can help ensure the growth of the company. This collection system should not only focus on getting the patients to settle their bill on time, it should also include a system that would allow the fast processing of claims. The people handling such system should have good skills when it comes to negotiating contracts with various third-party providers.
Saturday, April 23, 2016
Healthcare finance professionals are learning how to qualify patients for social security disability insurance. More importantly, hospitals, medical facilities and doctors are also using this strategy to increase revenues. Healthcare systems are facing many financial challenges today. The Chief Financial Officers for medical facilities are exploring and finding new ways to help patients who are disabled. According to the United States Census Bureau, “about 56.7 million people – 19 percent of the population – had a disability in 2010.” Medical finance professionals should take steps to improve their revenue cycle by expanding into Medicaid and disability social security programs.
Friday, April 22, 2016
With today's expanding medical industry, it's more important than ever to keep in mind that health and well-being are the first priority, not making money at the expense of your patients. By tailoring your package, you can build your brand image, ensure that your clients receive the high level of care that they deserve and give your bottom lines their full credit. Knowing the answer to the question, “what is revenue cycle management?”, and how it can be applied in your daily business operations is the proactive way to create and sustain a profitable enterprise. Even if you're only tasked with caring for a small local community, the information and ideas that you generate can have a global impact.
Thursday, April 21, 2016
DECO recently go featured on the July 2015 issue of the Healthcare Financial Management Association (HFMA) newsletter. The spotlight talked about the company in general as a provider of quality new health insurance marketplace coverage options and their partnership with the HFMA. DECO offers a number of programs and solutions which are aimed at assisting hospitals and health systems in converting bad debt into cash. Our company is also dedicated to helping hospitals maximize their third party self-pay revenue reimbursement in Social Security benefits for disabled individuals.
Tuesday, April 19, 2016
One of the keystone provisions of the Patient Protection and Affordable Care Act (ACA) was the expansion of eligibility for Medicaid to individuals up to 133% of the federal poverty level (FPL) beginning in 2014. Because children below 133% FPL were already Medicaid-eligible, this provision could provide health coverage to an estimated 16 million uninsured adults in addition to the subsidies to be provided to another 16 million people who purchase private insurance in a state-based Affordable Care Act Marketplace.