Maximizing Revenue Cycle Efficiency

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By Ann Knutson, CPC-A  The healthcare revenue cycle includes all administrative and clinical functions that involve capturing, managing, and collecting the provider’s/facilities revenue. The cycle includes three distinct parts of the practice/facility that’s referred to as the front-end, middle, and back end. Unfortunately, most of the time there is little coordination between the three areas which can lead to more claim denials and lost revenue for … Read More

Reduce Your Denials With These 4 Tips

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By Ranadene Tapio, MBA, CMRS, CPCS   Your practice seems to be doing everything right. You have a team in place, you’ve established your Revenue Cycle Management (RCM) process and you’re submitting claim after claim – but your denial rate isn’t going down. According to the American Academy of Family Physicians (AAFP), the average denial rate is between 5-10 percent. The result is the delay or cancellation of new practice initiatives that … Read More

Medical Necessity and the Revenue Cycle

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By Ann Knutson, CPC-A According to the Center for Medicare & Medicaid Services (CMS), medical treatment or supplies provided by a physician is considered medically necessary when they “are proper and needed for the diagnosis or treatment of your medical condition, meet the standards of good medical practice in the local area, and aren’t mainly for the convenience of your … Read More