Medical Billing and Revenue Cycle Management

  To enhance the financial experience of patients, it is crucial to closely examine an organization’s billing procedure. HealthLeaders is joining the celebration of Patient Experience Week from April 23-29 by highlighting the efforts of revenue cycle leaders in establishing a favorable financial experience for patients in their organizations. With a suboptimal financial experience capable of undermining a five-star clinical encounter, revenue cycle leaders are facing increased pressure to optimize processes for their patients. In light of this, where should organizations begin when aiming to enhance this aspect of patient experience? As Vice President of Revenue Cycle at Atrium Health, pointed out to HealthLeaders, there are several hurdles present in the current market that can impede a patient’s billing experience. Focusing on identifying and resolving these challenges can play a vital role in fostering a favorable financial experience for patients. https://www.allzonems.com/healthca

  In recent years, there has been an increase in scrutiny regarding the use of modifier -25 to identify separate evaluation and management (E/M) services on the same day as another procedure. Insurers are now demanding documentation of such services both before and after payment, leading to a significant administrative burden for urology practices. The reason for this burden is unclear. It may be due to an actual overuse of such services, or it could be a strategic decision by insurers to eventually discourage practices from reporting E/M services on the same date of service as procedures, potentially resulting in long-term cost savings for the payers. Regrettably, we have received reports that some groups have opted out of billing E/M services on the same date due to the high level of effort and expenses required to obtain proper reimbursement. Instead, these groups have chosen to provide free care or have patients return on another date for that aspect of their treatment. This is far