Claims Processing
Hospitals' struggle for financial sustainability continues and may be getting worse, as CFOs say information technology investments draw more resources than expected and threaten to crowd out other priorities.
It's the rare hospital that has never experienced delays in receiving reimbursement as a result of clinical documentation coding snafus. But hospitals that don't make a serious stab at clinical documentation improvement (CDI) will be poised to take an even harder hit come October 2015, the start date for ICD-10 implementation.
Commercial insurers inaccurately process about 20 percent of claims filed by medical practices. It's an industry standard that has weathered the test of time -- though not in a good way.
The offical transition to the ICD-10 coding set takes place next October (or so we hope). Many providers have already spent a good deal of money preparing for the inevitable, but even so, you need to make certain that select ICD-10 costs are included in your 2015 budget.
Like many other industries, healthcare is looking to leverage information technology to transform financial payments and automate the posting of accounts payable and accounts receivable processing systems. But which method to choose?
Some health systems see value in becoming part of branded health plan networks for limited provider plans, as other providers try to launch their very own plans.
With one year left, it's time to chart your map to the new code set. And given that so many payers and providers are lagging behind recommended timelines, these tactics will help you get organized.
According to the KISS principle, most systems work best if they're kept simple. Simplicity is the key goal in design, and unnecessary complexity should be avoided. Clinical documentation improvement and ICD-10 preparation are no exception.
With an annual rate of 11,000 fatalities from falls in U.S. hospitals, falls are a persistent concern for healthcare facilities. They raise issues of care quality and are increasingly a financial issue.
A Mississippi health system and three hospitals in Texas, Indiana and Alabama are illustrating how hospitals can thrive in a tough economic environment. The facilities recently won awards for their leadership in initiatives to improve financial sustainability and achieve significant financial performance improvements.