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Introducing Provider Revenue Cycle Management – Must-Have Features for Maximum ROI

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Introduction:

Medical billing mistakes can be easily made but have drastic repercussions on the overall profit of the healthcare organization. Returned claims with errors, denied claims, rejected bills, incorrect coding, and insufficient data are just a few of the many woes of poor revenue cycle management in healthcare. Almost 30% of medical bills are prone to medical billing errors. As common as these issues are, as complex as the system may be, the solution is at hand. As we sort through the commonality of medical coding errors and how to prevent them, how to correct medical billing errors, and steps in the medical billing process, certain areas reveal a gaping hole. Improper medical billing can be mitigated through healthcare revenue cycle management solutions.

As medical billing and coding errors increase in frequency, patient experience is diminished, profits are adversely affected, and the overall revenue cycle for healthcare is shunted. Efficient provider revenue cycle management can evade these outcomes through accurate claims management, offered through practice management solutions.

How We Built a Successful RCM System?

At OSP, A Texas-based mental health center wanted to automate the manual medical billing process. Paper-based practice management and the RCM cycle in medical billing were causing a loss of revenue and diminishing the quality of care. The main challenge for OSP was to bring in the digitization of the clinic’s daily practice and revenue operations.

We built a comprehensive revenue cycle management healthcare solution to offer:

Digitized Credentialing
Document Expiration Alerts
CAQH Management
Co-pay Management
Online Payment
A/R Management

HIPAA Compliant Solutions
Secure Patient Data Management
Secure Cloud-based System
Telehealth Appointment Management

Patient Engagement System

The Process – Steps of Healthcare Provider Revenue Cycle Management

Step 1: Revenue Cycle Management (RCM) is initiated when healthcare providers get patients to make the first appointment for medical services.

Step 2: Once the appointment is made, health staff begin the process of scheduling, eligibility verification, patient information collection, and account establishment. This Pre-registration process is a critical element of medical billing and revenue cycle management.

Step 3: When the patient arrives and completes the appointment, it is now time for claims submission. The provider will identify the type of treatment from ICD-10 codes and create a claim. Accurate coding is critical toward health revenue cycle management.

Step 4: Once the claim is created, it is submitted to the relevant payer for reimbursement. The insurance company will evaluate the claim and, if all goes well, the health provider is reimbursed for the service. This completes the revenue cycle management healthcare process.

The Challenges – Traditionalism in Provider Revenue Cycle Management

Healthcare compliance and regulations are continually changing and evolving. It is, therefore, difficult for health facilities to maintain a stable physician revenue cycle management policy.
Due to system hurdles, collecting the payments from patients before or at the point of service has become increasingly difficult.
Non-payment of medical bills by the patient increases the number of deductibles and creates a financial strain on the healthcare organization.
Striking a balance between ensuring that debts are collected while also preventing patients from seeking out competitive medical providers is complex.
Manual eligibility processes are prone to errors, and patients often do not understand their coverage options.
Tracking a claim through its entire lifecycle is a time-consuming process and requires additional staff for solely this purpose.
If not caught immediately, errors in billing can cause significant back and forth and delay the entire payment process.
Unidentified errors result in denied claims, which lead to a lack of revenue and decrease the bottom line of the health facility.
Training health staff toward physician revenue cycle management has turned into a pain point for healthcare organizations due to the job’s complexity.

The Future – Essential Features of Healthcare Revenue Cycle Management Solutions

1. Cloud Presence:

The future of healthcare provider software solutions is cloud-based solutions. A revenue cycle management solution is no exception. A solution on the cloud means that the health facility’s IT department no longer has to worry about space and bandwidth issues toward accessibility. Cloud computing in healthcare provides 24/7 accessibility of the solution without restrictions of space and hours. Medical records management is simplified when there is no stress about limits on data and accessibility. Another significant advantage of cloud-based RCM software is accessing electronic health records, even if the local system fails. This maintains patient data security from being lost through secure back-ups. Finally, if the system needs to be accessed across multiple locations, cloud-based access to integrated healthcare solutions is the best option.

2. Comprehensive Training:

RCM healthcare provider solutions should offer holistic denial management RCM training for the system for multiple functions. Training of healthcare staff in the organization should be organized in batches, and the revenue cycle management vendors should be prepared to offer the same. Organize the training in a manner that places the tech-savvy and relevant staff at the top of the list to address gaps in understanding at a later stage. Revenue cycle management services for healthcare should offer a demo of the customized software to ensure that all the services required will be present in the final version. This will eliminate development delays along the way. Additionally, incorporating healthcare analytics solutions within the RCM software will ensure advanced capabilities for the healthcare organization.

3. Highest Value Submission:

The goal of every healthcare organization is to maintain high profitability through healthcare automation. An essential factor in achieving this goal is ensuring that claims are submitted at their maximum value through medical informatics. Revenue cycle management for healthcare providers can be successful based on the criteria of highest value submission. When this policy is embedded into the RCM software, it can neutralize the effect of potential reductions in reimbursements since the value of the claim is at its highest potential. A well-integrated hospital-based physician RCM solution can better track claims values and not allow errors to slip through the cracks. Manual intervention is minimal, claims are processed faster through electronic data exchange, and the healthcare facility can expect a better bottom line.

4. Eligibility Verification:

The manual task of patient eligibility verification is cumbersome. Patients are routinely moving across different insurance coverage providers or to other plans. An automated and advanced RCM solution will swiftly manage the eligibility of patients with minimum manual intervention required. Data transactions can be conducted online to limit the complex processes of phone calls with patients and insurance agencies. Provider solutions for revenue cycle management hold automated checks of authorizations; patient responsibility amounts to optimally analyzing co-payments.

5. Tracking and Modification:

During the coding process, there is always a possibility of errors. Coding error possibilities are much higher when the process is undertaken manually. Incorrect coding rectification takes a long time and can affect overall healthcare management. Therefore, one of the most preferred providers revenue cycle management solutions features is automated coding and tracking. The process of automated coding restricts the possibility of errors. Even if there is a case of incorrect coding, real-time tracking and monitoring of status will highlight the error right away. Prompt modifications can then be undertaken for immediate rectifications.

6. Denial Alerts:

Another essential feature of futuristic RCM solutions is denial alerts. The easiest way to mitigate denials is to opt for an automated feature of predicting denial possibilities on the RCM platform. Through this capability, denied claims are flagged for immediate resolution, and any member of the medical billing team can quickly resolve the matter through re-coding. Through this ability of provider revenue cycle management solutions and healthcare interoperability, worker productivity increases, and a seamless payment processing flow is maintained across the organization.

7. KPIs and Reports:

An analysis of the revenue cycle management system is an analysis of the overall health of the organization. Therefore, periodic reports and Key Performance Indicators (KPIs) can be considerably beneficial when they are readily available for staff meetings and other purposes. A revenue cycle management provider software that can offer these reports in an automated and periodic fashion can boost the financial health of the practice to a large extent. Other factors, such as population health management, can also be included in these reports for additional gain. Weekly reports and KPIs can consist of relevant documentation, an analysis of timely completion of billing-related jobs, insurance protocols, and financial reports.

Conclusion

Provider revenue cycle management solutions have evolved to a large extent to accommodate the dynamics of healthcare organizational financial needs. Provider solutions in revenue cycle management can now streamline the entire lifecycle of financial, medical processes and provide accuracy like never before. Multiple technological advancements are deployed to track claims, collect payments, and resolve denials. Consequently, these solutions contribute significantly to generating a continual flow of revenue. As hospitals and other healthcare facilities actively incorporate provider solutions for revenue cycle management, it would be prudent for every health facility to analyze its particular demands. A customized solution is generally the best fit.

The post Introducing Provider Revenue Cycle Management – Must-Have Features for Maximum ROI appeared first on Osplabs.

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Cincinnati Reds Johnny Bench Sends a Message to Fiona on Her Birthday

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Fiona is celebrating her fifth birthday and everyone, including the Cincinnati Reds legend, Johnny Bench, the fifth catcher, is celebrating her birthday. Bench posed with a stuffed hippo and sent Fiona a special video message. Bench house stuffed animals. Represents the Cincinnati Zoo Fiona and all the wonderful animals. But Fiona is special. Happy birthday, Fiona. I also sent her birthday message, including her dad’s joke. “What do you call a hippo in a phone booth? I’m stuck.” Primitive scholar Jane Goodall sent Fiona a video message celebrating her fifth birthday. Goodall, a primatologist known around the world for his work on Cincinnati, congratulated Fiona on turning five. Zoo, here you are big and strong, “Goodall said in a video message. Fiona, who gave birth six weeks prematurely at the Cincinnati Zoo on January 24, 2017, weighs only 29 pounds at her birth and is 25 pounds less than her recorded minimum birth weight. She is her seed. She survived thanks to her tireless efforts to save her, encouraging many to take care of her species and wildlife.

Cincinnati —

Fiona is celebrating her fifth birthday and everyone, including the Cincinnati Reds legend, Johnny Bench, the fifth catcher, is celebrating her birthday.

Bench posed with a stuffed hippo and sent Fiona a special video message.

“This is one of our favorite plush toys at the bench house. It represents Fiona at the Cincinnati Zoo and all the wonderful animals. But Fiona is special. Happy Birthday, Fiona.”

The bench was one of the local legends wishing Fiona a happy birthday.

Drew Lachey also sent a birthday message, including his dad’s joke.

“What do you call a hippo at the phone booth? I’m stuck.”

Primatologist Jane Goodall sent Fiona a video message celebrating her fifth birthday.

Goodall, a primatologist known around the world for his research on chimpanzees, congratulated Fiona on turning five.

“I know you had a hard time getting into the world. Perhaps your mom did, but thanks to the people who took care of you at the zoo, you’re big and strong here.” Goodall said in her video message.

Fiona, who gave birth six weeks prematurely at the Cincinnati Zoo on January 24, 2017, weighed only 29 pounds at birth. This is 25 pounds less than the recorded minimum birth weight of her species. She survived thanks to her tireless efforts to save her, encouraging many to take care of her species and wildlife.

Cincinnati Reds Johnny Bench sends a message to Fiona on her birthday

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How to Determine If a KN95, N95 Mask Is a Counterfeit Product

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Since the beginning of the coronavirus pandemic, U.S. Customs and Border Protection officials have seized millions of counterfeit masks. Here’s how to find a fake:

As highly contagious Omicron variant of COVID-19 The surge continues in the United States, and the Centers for Disease Control and Prevention (CDC) has recently updated its guidance. Mask type Provides maximum protection to prevent the spread of COVID-19.

According to the CDC, proper respiratory organs, including N95, approved by the National Institute for Occupational Safety and Health (NIOSH) provide the highest level of protection against COVID-19. Meanwhile, the Federal Public Health Service says that about 60% of KN95 masks sold in the United States in 2020 and 2021 did not meet NIOSH standards and were therefore flagged as counterfeit.In fact, U.S. Customs and Border Protection officials Seized millions of counterfeit masks Since the start of the pandemic.Now many people online I’m wondering if there is a way to find a fake mask.

question

Is there a way to determine if the KN95 or N95 mask is counterfeit?

Source of information

answer

Yes, there is a way to determine if the KN95 or N95 mask is counterfeit.

What we found

The National Institute for Occupational Safety and Health (NIOSH) is a federal agency responsible for testing and approving masks and respiratory organs used in US workplaces.Before the mask is approved by NIOSH, it is the agency’s Respiratory approval programThis ensures that the mask and respiratory system meet the minimum structural, performance and respiratory protection standards.

NIOSH does not approve KN95 masks or other masks designed to comply with international standards. According to the CDC, the KN95 mask is manufactured in China and complies with the standards of the Chinese government.

Indicates that the N95 mask is NIOSH approved

NIOSH labels and numberes all masks it approves. Here’s how to find that information:

First, check the approval label on or inside the mask’s package, or look for the abbreviated approval of the mask itself. This certificate must include a number.

This approval number is NIOSH Certified Equipment List or NIOSH trusted source page..

NIOSH-approved masks always have one of the following:

N95
N99
N100
R95
R99
R100
P95
P99
P100

“If you have an unprinted N95, it’s probably not a real N95 and you’ll want to avoid using it,” said Nikki Vars McCullough, Global Technical Services and Regulatory Manager for Personal Safety. .. Mask maker 3M division.

Indicates that the N95 mask is forged

NIOSH lists how to detect if a mask may be forged On that website:

Filtering facepiece respirator has no markings
No Facepiece Respirator or Headband Filtering Approval (TC) Number
No NIOSH marking
NIOSH misspelled
Presence of decorative fabrics or other decorative add-ons (such as sequins)
Claims of Approval for Children (NIOSH does not approve any kind of respiratory protection for children)
The filter facepiece respirator has ear loops instead of a headband
The photo of the package is not clear

You can also look for alerts about specific products that are known to be fake.

If NIOSH becomes aware of a counterfeit mask or fake NIOSH approval, the agency will typically post a photo of the mask and its packaging online to warn users, buyers and manufacturers. click here Shows a list of the latest NIOSH counterfeit masks.

Show that your KN95 is genuine

ECRI, the largest patient safety organization in the United States, Announce research In September 2020, it was found that up to 70% of the nearly 200 KN95 masks tested did not meet NIOSH standards for efficacy, and many imported KN95 masks, as the name implies, accounted for 95% of aerosol particles. It turned out that it was not filtered. However, although ECRI’s vice president of technology and safety, Michael Argentieri, said that KN95 does not meet US regulatory standards, it “generally provides greater respiratory protection than surgical or cloth masks.” It states.

Kelly Carrosers, Director of Government Affairs Project N95, VERIFY Sister Station WTHR told There is one trick to make sure the KN95 is genuine.

“You need to look at the side of the mask, which should say GB2626-2019 or GB2626-2006,” Carothers said.

What to look for when shopping online

During the pandemic, many people used sites like Amazon to buy masks. question The authenticity of masks sold on the Amazon Marketplace. An Amazon spokesperson told VERIFY in a statement that the company had “a rigorous seller review and product review process to ensure compliance with applicable laws, regulations and Amazon policies.” rice field.

“Before listing N95 and KN95 masks in our store, we supply them from a trusted manufacturer by examining the supplier’s invoice, tracking inventory, checking packaging and product descriptions, and comparing with CDC’s counterfeit mask list. Make sure it is done, “said a spokeswoman.

Amazon customers can also contact the company’s customer support team to refund the full amount of their order if the product does not arrive or does not arrive as advertised.

According to NIOSH, there are a few things to keep in mind when buying masks online.

If you claim that your listing is “legitimate” and “genuine,” it may not be.
If the retailer or manufacturer claims that the KN95 mask is NIOSH approved
If possible, check transaction history and reviews
Will there be any changes to the items sold over time (high or low transaction period)?
Are there any price fluctuations or fluctuations? (Is it too good to be true?)
Look at the quantity the buyer has in stock
Does the seller violate the marketplace policy and hide contact information in the image?
Is your primary contact email address connected to your website or is it a free email account?
Look for bad grammar, typos, and other errors
Note the cookie cutter website where the seller exchanges some websites

How to report counterfeit masks

Before reporting a counterfeit mask to NIOSH, the agency will check the TC approval number (such as TC 84A-XXXX) to see if the identified mask is counterfeit or misrepresents NIOSH approval. It states that it needs to be done. NIOSH certified equipment List and verification Required approval marking.. next, False Respirator / NIOSH Approved Web Page Misrepresentation Check if the respiratory system is listed.

If the mask is not listed, you can send an email to PPEConcerns@cdc.gov More about the respirator. If possible, NIOSH is telling you to include a photo of the mask and its packaging in your submission. People can also report counterfeit COVID-19 products, including masks, to the Food and Drug Administration (FDA) by email. FDA-COVID-19-Scam-Products@fda.hhs.gov

Details of VERIFY: Yes, you can reuse the KN95 and N95 masks several times.Here’s how to do it right:

The Confirmation The team distinguishes between facts and fiction so that they can understand what is true and what is false.Consider our daily subscription Newsletter, Text alert And our youtube channel..You can follow us too Snapchat, twitter, Instagram, Facebook When Ticktaku.. learn more “

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Want to verify something?

Text: 202-410-8808

How to determine if a KN95, N95 mask is a counterfeit product

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Road Recommendations After Snowy Weather

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LIMA —Sunday morning winter weather left slippery, snow-covered roads in counties in some areas. Several counties have declared Level 1 road recommendations.

Allen County Sheriff Matt Treglia declared Level 1 at 10:11 am. He warned that snow- and ice-covered roads could drift. Great care should be taken as operating conditions can be dangerous.

Auglaize County Sheriff Michael Vorhees issued Level 1 on snowy or ice-covered roads at 11:00 am.

Jeff Gray’s office, Sheriff of Mercer County, reported that several cars had slipped off the road, but did not make any recommendations.

Hancock County Sheriff Michael Heldman issued Level 1 at 9:55 am, focusing on dangerous roads.

A snowplow passes through the intersection of Force Street and Locust Street in Ottawa on Sunday morning.

https://www.limaohio.com/wp-content/uploads/sites/54/2022/01/web1_Snowplow.jpgA snowplow passes through the intersection of Force Street and Locust Street in Ottawa on Sunday morning.

Road recommendations after snowy weather

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Original Source: ohionewstime.com

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