At the Margins

Our latest insight into health care margin improvement efforts

How to bill for Covid-19 testing and treatment

by Rachel Matthews March 20, 2020

Editor's note: This blog was updated on May 19, 2020.

In a race to support the hospitals testing and treating COVID-19 patients, CMS and the American Medical Association (AMA) have announced new billing codes for COVID-related services. We've compiled the codes below to help providers document and track care delivery in this important time.  

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Want to reduce inpatient denials? Target these 3 service lines.

by Rachel Matthews February 19, 2020

A successful denials strategy centers on denials mitigation, not management. Reworking claims during appeals is both timely and costly. As one organization recently told us, "As soon as you're appealing the denial, you've already lost."

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How to make 2020 the year of revenue cycle excellence

by Rachel Matthews January 22, 2020

It's the start of a new decade. While some may take this opportunity to set personal resolutions, the Revenue Cycle Advancement Center would like to challenge you further—why not make 2020 the year of revenue cycle excellence?

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Alternative funding for care should prompt system change

by Robin Brand and Sophia Duke-Mosier December 18, 2019

It's a message that revenue cycle leaders and staff are all too familiar with: Health care costs are rising. Yet while these increasing costs represent a dismal state for health care, they have encouraged individuals and organizations to come up with creative ways to work outside the existing system and fund care—but should providers be taking the lead on alternative funding?

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How physician advisors can save you from a clinical crisis

by Caleigh Dwyer and Robin Brand December 11, 2019

As hospitals wage war on persistent margin problems, denials prevention remains a key strategic priority. And while our 2019 Hospital Revenue Cycle Benchmarking Initiative suggests a drop in overall denial write-offs, data on the reason for initial and denial write-offs indicates an important shift since 2017.

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The secret to 7.6 percentage point margin growth? Invest in your revenue cycle.

by Rachel Matthews and Robin Brand November 20, 2019

Editor's note: This blog post was updated on November 20, 2019.

While many health systems hope to accelerate growth through new revenue streams, recent Advisory Board modeling suggests a renewed focus in revenue cycle can lift hospital margins to the tune of 7.6 percentage points.

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CMS' latest transparency rules: A true game changer or much ado about nothing?

by Christopher Kerns, Eric Fontana, Yulan Egan, and Rachel Hollander November 19, 2019

On Friday, CMS released two highly anticipated rules that aim to increase price transparency among health care providers and insurers.

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You don't have to list your negotiated rates (yet): Our 3 key takeaways from the HOPPS final rule

By Eric Fontana, managing director, Revenue Cycle Advancement Center, and Rachel Hollander, senior analyst, Health Care Advisory Board November 4, 2019

On Friday evening, CMS released its latest set of finalized regulations for hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs) in calendar year (CY) 2020. Our team is in the midst of breaking down the full implications of the rule, including new prior authorization requirements and ongoing cuts to the 340B drug program. We'll cover all of the details in our November 13th webinar.

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