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New BLOG Post: Mastering Patient Eligibility and Demographics Navigating the intricate world of Federally Qualified Health Centers (FQHCs) demands a keen focus on patient demographics and eligibility. Dive into our latest blog where we unravel the blueprint for mastering these crucial elements, paving the way for financial sustainability and seamless operations in your FQHC. 🔍 Challenges Explored: ➡️Documentation hurdles ➡️Complex insurance verification ➡️High no-show rates ➡️Limited technology resources ➡️Staff turnover impacts 💡 Strategies for Success: ➡️Precision in insurance identification ➡️Advance verification using technology ➡️Understanding the payer landscape ➡️Standardized procedures for consistency ➡️Automated outreach for efficiency 💰 Financial Sustainability Awaits: Discover how leveraging advanced technology and strategic processes can not only optimize revenue cycles but also ensure equitable access to quality healthcare for underserved communities. Let's embark on this journey towards a brighter, more sustainable healthcare future! #FQHC #HealthcareFinance #RevenueCycleManagement https://hubs.li/Q02vySLL0

More than 70 million Americans participated in a #HealthSavingsAccount in 2023, and that number is expected to increase for 2024. So, who are HSA members? According to the American Bankers Association (ABA), 75% of HSA members are from households earning less than $100,000 annually and more than 80% of account holders receive employer contributions. This infographic from ABA highlights additional facts about HSA utilization and demographics. https://lnkd.in/gh6XXyAa #HSA #retirementplanning #healthcare

With our Denials Navigator, you can tackle denial challenges with unparalleled efficiency and precision. This revolutionary tool monitors your denial inflow and alerts your staff early to payer behavior changes. Contact our team today to request a demo and get ahead of payer tactics. Click here: https://lnkd.in/gdA3Jrs3 #healthcare #revenuecycle #denials #claimsmanagement

Before submitting a claim – take a moment! This quick checklist can save you time and money: Patient Info: ☐ Insurance eligibility verified and up-to-date ☐ Pre-authorization obtained if required ☐ Patient demographics accurate (name, DOB, address, etc.) ☐ Financial responsibility policy reviewed with patient Documentation: ☐ Correct CPT codes for procedures performed ☐ ICD-10 codes specific and support medical necessity ☐ All supporting notes clear and legible Claim Form: ☐ No blank fields or typos ☐ Correct provider and billing information ☐ Matching dates of service #MedicalBilling #Healthcare #HealthcareProviders #MedicalPractice #ClaimAudit #RevenueCycleManagement #Claims #CPTCodes #ICD10Codes #MedicalCoding #CodexMedical

🧨Patient demographics play a crucial role in medical billing, ensuring accurate and efficient claims processing. Here's why:🧨 Importance of Patient Demographics: 1. Accurate Claims Submission: Demographic information helps ensure claims are submitted to the correct payer and patient. 2. Insurance Eligibility Verification: Demographics facilitate insurance eligibility verification, reducing claim denials. 3. Patient Identification: Unique demographic information identifies patients, preventing confusion or misidentification. 4. Compliance with Regulatory Requirements: Accurate demographics ensure compliance with HIPAA, Medicare, and Medicaid regulations. 5. Data Analysis and Reporting: Demographics provide valuable insights for healthcare analytics and reporting. 6. Revenue Cycle Management: Accurate demographics streamline revenue cycle processes, reducing delays and denials. 7. Patient Engagement: Demographics facilitate patient communication, enhancing engagement and satisfaction. ✨Key Patient Demographic Elements:✨ 1. Name 2. Date of Birth 3. Social Security Number (SSN) or Medicare ID 4. Address 5. Phone Number 6. Email 7. Insurance Information (payer, policy number, effective dates) 8. Employer Information (for workers' compensation claims) 9. Emergency Contact Information 🎗Consequences of Inaccurate Demographics:🎗 1. Claim denials 2. Delayed or lost revenue 3. Compliance issues 4. Patient dissatisfaction 5. Inefficient revenue cycle management 🎐Best Practices:🎐 1. Verify demographics at patient intake 2. Update demographics regularly 3. Use automated demographic verification tools 4. Train staff on demographic importance 5. Conduct regular audits to ensure accuracy By prioritizing accurate patient demographics, healthcare providers can optimize medical billing processes, reduce errors, and improve revenue cycle efficiency

Oscar Health is improving diabetes care for its members by going beyond basic check-ups. Here's what's new: From Check-Ups to Care Journeys: Oscar is shifting its approach from one-time reminders to personalized, multi-step "Care Journeys." Designed specifically for diabetics, these journeys provide ongoing support, relevant information, and actionable steps. Member-focused Care: - Research-driven: Oscar understands the desire for simplicity and empowerment among chronically ill individuals. - Personalized communication: Oscar tailors messages to each member's specific health needs and plan benefits. - Clear & Compassionate: Oscar fosters trust with members through straightforward and empathetic communication. New Features: - Oscar Care Mail: A unique email series resembling a care package, emphasizing the importance of information and ongoing support. - Oscar-Branded Badges: Virtual "high-fives" triggered by positive health actions, keeping members motivated. Learn more: https://hubs.ly/Q02vHFQB0

I was honored to have been interviewed by the NYT Opinion Video team on the critical issue of prior authorizations in healthcare. While my contribution was brief, the collective voices of doctors and patients in this video are essential for driving change in our healthcare system. Huge thanks to the NYTimes Opinion Video team for shedding light on this crucial topic. #PriorAuthorizations #NYTimes #HealthcarePolicy #PhysicianBurnout #InsurancePolicy #Medical #Denials #healthcarereform https://lnkd.in/gmJtrQTH

There are now proven treatments available for obesity management, but getting them covered by insurance can be a real challenge. Here are practical suggestions for getting coverage for the obesity care you need... #MyWeight #healthinsurance #obesity #coverage #healthcare

Struggling with #claimdenials? Explore the secrets to preventing them! Our latest blog post covers everything you need to know: 🔍 What do Claim Denials Refer to? 📋 Types of Denials in RCM 🛑 Reasons for Denials in RCM 💡 Strategies to Avoid Claim Denials Don't let #denials disrupt your #revenuecycle. Click here to know more: https://lnkd.in/gcSYXRSc #QWay #QWayHealthCare #RCM #Healthcare #RevenueCycleManagement

"These findings suggest that experiences of patients seeking free preventive care differ on the basis of their demographics, leading to inequities in accessing basic preventive care." ... "... at-risk populations, including low-income patients, patients with a high school degree or less, and patients from minoritized racial and ethnic groups, experienced higher rates of claim denials. The most frequent denials were noncovered service–diagnosis code pairs and billing errors." This is unacceptable and should not be happening in a modern, first world health care system with so much money sloshing around. The high-value health care services (#VBID VBID VBID!!!) are critical to both a healthy populace but also avoiding much more pain, suffering, and spending later on. https://lnkd.in/eFBzZRdi