Claims denials have increased by 11% nationally since the onset of the COVID-19 pandemic, according to an analysis. Almost half of claims denials are caused by front-end revenue cycle issues, including registration/eligibility, authorization, or service not covered. Implementing a process to check eligibility at multiple points throughout the revenue cycle will go a long way in preventing this common denial from occurring.
Patients often are left alone to navigate the complex healthcare system, which can cause problems. The most successful financial navigation programs direct healthcare providers and staff to work together to address patients’ needs from the time they enter the system to after discharge.
The American College of Obstetricians and Gynecologists has released a practice bulletin to help providers use scientific evidence to guide women with coexisting medical conditions in making the most effective choices.
Patient access staff at Unity Point Health System — Rock Island (IL) occasionally see patients who reside in Iowa. There is a marked difference in how self-pays are handled in the two states. The reason is that Iowa offers a larger eligibility criteria for presumptive eligibility, which “has been a big revenue producer and a godsend for a lot of patients.”