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February primeCLAIMS Blog Spotlight

By Prime Care Tech Marketing on Thu, Feb 25, 2016 @ 02:00 PM

iStock_000023184029_Small.jpgPresent on Admission, handling rejections, and shortening the revenue cycle topped this month’s key claims management blogs. Here are the key topics for this month:

To get paid or not, the answer could be a simple “Yes” or “No” – POA

Some SNF providers strongly assert that HAC-POA (Hospital Acquired Condition-Present on Admission) indicators do not apply to claims submitted to SNFs. Yet, recently an entire batch of claims submitted to a large insurance carrier was rejected, because the SNF provider’s billers had not included the POA indicator.

  • What is a Present on Admission Indicator?
  • Why POA could be important to SNFs
  • How should billers use the POA?

No pain, no gain–not true. 4 ways to deal with claims rejections pain

One of the pervasive and overlooked pains in claims management involves claims rejections. Claims rejections require the billing staff to review the claims, address whatever is missing or in error and resubmit the claims in order to get paid. In some cases, payers reject specific claims over and over again. What’s even more painful is that billers, with the best of intentions, sometimes will put the rejected claims in a file folder which, if not dealt with immediately, can collect dust. Are you feeling the throb?

  • Pay attention to rejections
  • Discover the issue and if it is something you can control, address and fix it quickly.
  • Check the contracts.
  • You may have to stop accepting certain insurances/payers.

3 unique ways to shorten revenue cycles

LTPAC CFOs in the 21st century have to be concerned about many things. But in reality, much of what CFOs do revolves around getting paid on time in the amounts anticipated. Perhaps paying attention to the not-so-obvious factors influencing payment may be worth investigating.

Three ways to shorten the revenue cycle by “developing and leading the finance team to maximum productivity and responsiveness”:

  • Improve A/R team job satisfaction
  • Address claims processing costs
  • Pay attention to Medicare Secondary Payer (MSP) claims

Claims Process

Topics: claims rejections, POA, POA indicator, revenue cycle, Present on Admission, shorten revenue cycle

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