Wednesday, April 26, 2017

Social Security Disability Eligibility Cuts Treating-Physician Rule, Keeps Appeal Waiting Times Long

The Social Security Disability program benefits millions of Americans, no matter how old or young they are. However, a new rule imposed by Social Security recently may make it harder for any patient of any age to be approved for social security disability eligibility. This is because the administration has recently introduced a new rule where doctors’ reports would no longer be used to determine an individual’s eligibility to receive benefits.

Rule changes such as this present additional challenges to hospitals and healthcare institutions trying to determine if their patients qualify for disability benefits.

Social Security Administration Announces an Update to Its “Treating-Physician Rule”

The Social Security Administration has just said that it will now eliminate the use of what is known as the “treating-physician rule” as a basis of disability eligibility. The said rule refers to Social Security’s previous practice of giving a doctor’s report significant weight in supporting a person’s disability entitlement. Previously, Social Security adjudicators are required to consider evidence of disability as presented by the medical professional treating the claimant.

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Monday, April 24, 2017

New Bill Offers Disability Social Security Beneficiaries a Pathway Back to the Workforce

Americans who are on disability social security may soon find themselves back to work the moment they are able to. A new proposed bill in Congress aims to give recovering beneficiaries a pathway back to the workforce. This would give them the chance to start their life over after going through a series of medical treatments and recovery.

Earlier this year, Rep. French Hill, R-Ark. had introduced the Social Security Disability Insurance Return to Work Act of 2017 in the House of Representatives. On the other hand, Senators Tom Cotton, R-Ark.; Mike Lee, R-Utah; and Marco Rubio, R-Fla. introduced a companion bill in the Senate.

Hospitals and healthcare facilities need to be aware of these proposed changes so they can properly assess their patients’ eligibility for the program.

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Sunday, April 23, 2017

Why Eligibility for Social Security Disability Remains a Challenge for Some

The difficult process of filing for benefits is causing the social security disability program to fail many of the people it’s supposed to serve. A combination of administrative inadequacy and far too rigorous requirements have only managed to deny benefits to some deserving claimants. This provides hospitals and healthcare institutions with an opportunity to improve their revenue cycle management processes by helping their patients with SSDI eligibility problems.

Background on SSDI

The social security disability program was created to help people who are unable to work due to a disability. In the event that able-bodied individuals suddenly become injured or fall ill, they can have some financial relief to look forward to.

These benefits are also extended to children who suffer from disabilities or conditions that prevent them from fully functioning. The extension of the benefits to disabled children is meant to relieve parents of the cost of providing for whatever special needs they may have.

This, however remains to be only an ideal for some people. In fact, even if they have been religiously contributing, they may still find it difficult to meet the requirements for eligibility for social security disability. Read more on this article:

Friday, April 21, 2017

The Affordable Care Act Marketplace Is Under Threat as Insurers Stand to Lose Federal Subsidies

All over America, uncertainty continues to loom when it comes to the future of healthcare insurance. In recent months, the Republican party has worked hard to repeal and replace the Affordable Care Act or Obamacare. Their version of Obamacare, dubbed as the American Health Care Act, presented challenges to both individuals and healthcare facilities with possible changes with their health plans.

However, this attempt failed to secure enough votes to introduce a new healthcare system being supported by President Donald Trump and several members of the Republican party. Following this, President Trump said that the Affordable Care Act would stay in place in the meantime as the GOP carefully plans how best to approach the overhaul of the U.S. healthcare system.

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Wednesday, April 19, 2017

Work Requirement May Soon Help Determine Eligibility for Medicaid Benefits

For quite some time now, Medicaid has been the most widely available source of health coverage for people living across the United States. Through this program, over 72.5 million Americans, particularly disabled individuals, pregnant women, children, and seniors, were able to gain affordable health coverage. Due to recent events, however, many of them are at risk of not being able to avail of Medicaid when they would need it most.

After the recent collapse of the proposed American Health Care Act or AHCA, there has been increased interest among the Republicans to add work requirement into the eligibility for Medicaid. In fact, Department of Health and Human Services Secretary Tom Price and Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma both sent letters to various state governors, giving them greater flexibility when it comes to approving Medicaid Section 1115 waivers. At the same time, these include a number of work-related proposals. 

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Tuesday, April 18, 2017

CMS Looking at New Health Insurance Marketplace Coverage Options by 2018

Even as the Affordable Care Act (ACA), otherwise known as Obamacare, survives to live another day, the seeds of doubt have already been planted in the minds of the insurers. Is it on its way to a more sustainable future, or is this but a temporary reprieve from the threat of repeal and removal?

Waiting in the Dark

For most health insurers, it’s a lot like a waiting game--and in the dark, too. The new administration had been very vocal about providing a new model for the health insurance marketplace, but this confidence was doused by failure to gain approval from Congress. As a result, many of the providers are choosing to tread lightly, opting not to commit fully about staying on in the program, at least until the new administration does offer a clearer stand about what it intends to do about healthcare policies. Read more on this article:

Monday, April 17, 2017

Avoiding Denied Claims is Crucial to Good Hospital Revenue Cycle Management

According to a report by Relay Health Financial, large hospitals in the Northern Plains have higher average claim denial rates compared to other areas in the country at a surprising 10.58%. The report defines large hospitals as facilities that host 250 to 400 beds. The percentage was derived by comparing the claims dollars that were denied relative to revenue successfully billed on the claim.

The South Central region, meanwhile, topped the list among mid-sized hospitals (100-250 beds), with a denial rate of 8.82%. The region also ranks second among large hospitals, registering a denial percentage of 8.8%.

Of course, as any healthcare executive knows, denial rates are simply part of business. After all, insurers closely scrutinize each claim to see if they should indeed pick up the tab for the patient. However, keeping denial rates to a minimum is a crucial part of hospital revenue cycle management. After all, when claims are denied, unpaid bills have a higher chance of becoming potential bad debt.

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Wednesday, April 12, 2017

Medicaid Expansion Shown to Improve Healthcare Revenue Cycle Management

Operating a healthcare facility is no mean feat. For hospital executives, the task involves not only providing excellent medical care to patients, but it also means keeping a business afloat. After all, a hospital is an expensive venture to run—almost all of its manpower are highly skilled professionals, and the facility uses advanced equipment to help diagnose and treat ailments.

As such, keeping a healthy bottom line is crucial to any hospital’s survival. However, unpaid medical bills prove to be an all too real threat. According to a report from The Tennessean, about half of all hospital bills go unpaid. Healthcare executives know that potential bad debt can hobble their facility’s ability to deliver excellent care to the infirm.

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Tuesday, April 11, 2017

Envisioned New Tax Plan May Affect Even Social Security Disability for Children

The supposed ACA replacement may have fallen through, but people relying on social security shouldn’t heave a sigh of relief just yet. A new tax reform is being worked on, and analysts are purporting that this might affect social security itself. The uncertainty has hospitals and healthcare facilities worried about the continued eligibility of many of the patients they serve.

The Status Quo

The payroll tax is similar to income tax, but the main difference between the two is that the former funds employee benefits, while income tax is what is owed to the government. In the current set up, the payroll tax funds Social Security and a portion of Medicare as well. This tax is generated by deducting a percentage of the worker’s wages, with the employer contributing an equal amount. Read more on this article:

Monday, April 10, 2017

What is Revenue Cycle Management in the Age of Healthcare Consumerism?

For the longest time, the healthcare industry’s status quo has been more or less intact. Yes, technological advances have been introduced, but the way hospitals conducted business was mostly the same: patients come in, they get treated, then they get billed.

However, public policy driven changes have led to a shift in the way patients receive medical treatment. For one, there are more walk-in clinics and ambulatory care centers that offer many of the services one could find only in a hospital years past.

Moreover, more patients are opting for high deductible plans from the health exchanges, which means that more of their medical costs are being paid out of pocket. Many feel that this is a more cost-effective option, especially those who are relatively healthy and very rarely get sick.

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Friday, April 7, 2017

In an Era of Healthcare Consumerism, Revenue Cycle Management Companies Help Hospitals Stay Afloat

For the foreseeable future, the Affordable Care Act or ACA is here to stay. With its continued implementation, the law continues to change the healthcare landscape as Americans know it.

More specifically, the landmark law has spurred a change in the way patients look at—and acquire—healthcare services. According to a 2016 report by InstaMed, healthcare providers saw a 74% increase in patient financial responsibility.

Data shows that during the 2016 open enrollment period, 90% of the 12.7 million people who got coverage from the health exchanges got a high-deductible plan. Compared to 2006 figures, this represents a 225% increase in out-of-pocket expenditures during hospital trips.

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Wednesday, April 5, 2017

To Reverse the Rate of Unpaid Bills, Outsource Your Revenue Cycle Management Services

Over the tenure of the American Health Act (ACA), some observers have blamed it for the rise of unpaid patient bills at hospitals. Following the failure of House Republicans to replace the ACA with their own American Health Care Act, hospitals have come up with a new strategy to deal with a rising volume of unpaid bills. They bill the patient before any medical service is actually done. Hospitals are forced to try out this option because insured Americans are still required to spend thousands of dollars before their actual insurance payments ensue.

The ACA Has Led to Greater Unpaid Bills Over Time

In recent years, the ACA extended insurance coverage to as many as 20 million Americans. Initially, this allowed hospitals to reduce debt from uninsured patients who had originally been unable to pay their medical bills.

As time went on, however, more Americans on ACA plans have chosen insurance with low monthly payments, resulting in a trade-off with dire consequences. Patients now have to deal with higher out-of-pocket costs the moment they need medical care. As a result, hospitals must deal with a higher percentage of unpaid bills as patients continue to face the same dilemma over and over again when it comes to healthcare plans. Read more on this article: