The Importance of Identifying
Do black holes negatively impact financial performance? Yes, almost always. Does every hospital have black holes? Yes, almost always. Black holes are defined as a region of space from which nothing, not even light, can escape. In healthcare, this tra...
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Effect of Patient Protection and Affordable Care Act on Hospital Pharmacies
This edition of IMA Insights explores some of the effects the Patient Protection and Affordable Care Act (PPACA) will have on hospital pharmacies. The article does so in the context of continuing healthcare reform focusing on reducing waste from with...
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Healthcare Reform Should Cause You to Review Your Compliance Program
Beginning in 1998, hospitals received guidance from the Department of Health and Human Services regarding how to develop and manage their compliance program. Additional provider types have received similar guidance specific to their industry. The opp...
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Sustaining Operating Margins for the Long Term
This issue of IMA Insights explores the implications for hospitals of recent and forecasted trends in patient services revenues and operating expenses. This article does so in the context of the continuing healthcare reform focusing on reducing waste...
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The Importance of Medicare Hospital Cost Report Reviews
Complex issues concerning Medicare hospital reimbursement continue to present significant challenges for providers, as the perceived diminished importance of Medicare hospital cost reports has been greatly exaggerated. Interpreting proposed and final...
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Manage Your Payer Contracts to Optimize Collections
Could you be receiving underpayments from as many as 40% of your payers? It's possible. Underpayments are among the major challenges hospitals face today, whether the result of complex or ambiguous contracts, inadequate information systems, or other ...
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The Challenges of Medicare Bad Debt Reimbursement
Reimbursement issues concerning Medicare Bad Debt (MBD) continue to present significant challenges for providers. Interpreting recent court decisions, the potential revision of bad debt policies in association with returning accounts from collection ...
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Healthcare Reform Will Force Hospitals to Make Cost Decisions
This issue of IMA Insights presents expense management considerations for hospital leaders in preparing for the potential impact of the coming healthcare reform legislation. While many aspects of the reform act remain uncertain, one facet stands clea...
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Enhance Net Revenue by Improving Your Denial Management Program
Payer denials represent one of many revenue cycle challenges where prevention really is the best cure. There is always a cost associated with a claim denial. Whether it is the cost of researching the claim, filing an appeal, coordinating the provider...
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Outpatient Prospective Payment System (OPPS) Final Rule
In the 2009 Outpatient Prospective Payment System (OPPS) Final Rule, the Centers for Medicare and Medicaid Services (CMS) issued a restatement and clarification of the requirements for physician supervision for "incident-to" billing. This clarificat...
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Give Patient Access The Necessary Supporting Technology For The Job
Patient Access Department performance continues to grow in importance, as the financial impact and customer service ramifications of front-end revenue cycle activities become better understood and appreciated. Beginning with the scheduling process, ...
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Proposed reimbursement reductions
This issue of IMA Insights focuses on ways to prepare for the proposed reimbursement reductions for healthcare services, as the push for healthcare reform continues. Planning and taking actions now can forestall the continued erosion of operating mar...
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Are Unbilled Accounts Jeopardizing your Cash Collections?
Maintaining an optimum cash flow is an ongoing challenge, and if your hospital is not effectively managing the Discharged Not Final Billed (DNFB), you probably have too much revenue being held until a final bill can be produced. Simply stated, until ...
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How RAC Preparation and Your Compliance Plan Can Work Together
Different from other initiatives in the past, whether it be IL-372, Lab Audits, Evaluation and Management documentation or old fashioned fraudulent/abusive activities, etc... where a whistle-blower (disgruntled employee) was the catalyst for a long i...
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Identity Theft Compliance for Healthcare Providers
Technology dominates our daily existence more than ever. From online banking, to Internet shopping, to web-based applications, to electronic patient records, we depend upon technology personally and professionally. Much of this electronic data contai...
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Hospitals' Response to the Current Financial Market
In the past six weeks, the crisis in the financial markets led the United States Congress to enact the Emergency Economic Stabilization Act of 2008. While it is far too early to predict whether the actions prescribed in the Act will address the finan...
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