Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

Medical Billing

Top 4 Patient Financial Responsibility Collection Methods

June 12, 2017 - The top priority for providers is to deliver high-quality healthcare services to their patients. But the recent rise in patient financial responsibility and healthcare consumerism has forced some providers to bump patient collections to the top of their priority lists. Approximately 74 percent of healthcare providers reported a significant increase in patient financial responsibility in 2015...


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2016 Medicaid, Medicare Improper Payments Over Regulatory Cap

by Jacqueline Belliveau

A recent Office of the Inspector General (OIG) report revealed that the rates of Medicaid and Medicare improper payments in 2016 exceeded the legislative threshold of less than 10 percent. The improper payment rate for Medicare fee-for-service...

Third MI Provider Convicted in $17.1M Healthcare Fraud Case

by Jacqueline Belliveau

Healthcare fraud prevention and prosecution will continue to be a major area of focus for the Department of Justice (DoJ), Acting Assistant Attorney General Kenneth A. Blanco recently told the American Bar Association. With healthcare fraud draining...

Is Billing Some Patients at Hospital Chargemaster Rates Legal?

by Jacqueline Belliveau

Contract law does not uphold the medical billing practice of charging uninsured or out-of-network insured patients hospital chargemaster rates that are not based on actual healthcare costs or market-negotiated prices, argued authors of a recent...

Patient Financial Responsibility Not Owed Top Medical Debt Issue

by Jacqueline Belliveau

A recent report from the think tank Frontier Group and the US Public Interest Research Group (PIRG) Education Fund may spell trouble for providers attempting to collect overdue patient financial responsibility either internally or through a debt...

Credit Card On File Program Key To Patient Collections Success

by Jacqueline Belliveau

Implementing a credit card on file program boosted patient collections and reduced accounts receivable by 28 percent in six months at Orthopaedics & Rheumatology of the North Shore, a four-physician specialty practice in Illinois. Consumers...

28% of Adults Say Docs Discuss Patient Financial Responsibility

by Jacqueline Belliveau

Patients are still trying to figure out and compare healthcare prices, a recent Public Agenda survey showed. Yet only about 28 percent of the over 2,000 adults Americans surveyed said that their provider or their staff have discussed patient...

Preparing Providers for the Healthcare Consumerism Shift

by Jacqueline Belliveau

With a couple of swipes and clicks, patients are driving the shift to healthcare consumerism in the palm of their hands. But many healthcare organizations are not finding it as easy to align their care delivery and patient collection strategies...

Only 20% of Providers Offer Card-On-File Patient Collections

by Jacqueline Belliveau

Even though patient financial responsibility continues to grow, a recent Navicure survey showed that many healthcare organizations are not meeting patient collection needs, such as electronic payments. Th survey of providers and patients from...

GA Dentist Sentenced to Prison for $1M Medicaid Fraud Scheme

by Jacqueline Belliveau

A dentist from Georgia faces one and a half years in federal prison after she reportedly participated in a Medicaid fraud scheme totaling almost $1 million, the Department of Justice (DoJ) recently announced. From 2009 to 2013, Oluwatoyin Solarin,...

4 Key Ways to Boost Point-of-Service Patient Collections

by Jacqueline Belliveau

In a time of healthcare consumerism and high-deductible health plans, the patient has become a major revenue source for healthcare organizations. But without strong point-of-service patient collection strategies, providers could be seeing their...

OIG: NJ Agency Falsely Claimed $95M in Medicaid Reimbursement

by Jacqueline Belliveau

New Jersey’s Department of Health and Human Services may have to repay the federal government almost $95 million after the Office of the Inspector General (OIG) recently found that the state agency received improper Medicaid reimbursement...

Unexpected Patient Financial Responsibility in 20% of ED Cases

by Jacqueline Belliveau

Approximately 20 percent of hospital admissions stemming from an emergency department visit in 2014 led to unexpected patient financial responsibility in the form of surprise medical bills, a recent Health Affairs study reported. Using national...

How a Small Hospital Increased Patient Collections by 300%

by Jacqueline Belliveau

As patient financial responsibility continues to increase in a more consumer-focused healthcare environment, more hospitals are shifting healthcare revenue cycle management strategies to improve patient collections. Iroquois Memorial Hospital...

HHS Unveils Simpler Medical Billing Process Challenge Winners

by Jacqueline Belliveau

The Department of Health and Human Services (HHS) recently announced two winners of a medical billing competition that sought a simpler patient payment collections experience. The “A Bill You Can Understand” competition, sponsored...

4 Medical Billing Issues Affecting Healthcare Revenue Cycle

by Jacqueline Belliveau

Medical billing is the backbone of healthcare revenue cycle management, but many providers experience significant challenges with efficiently and accurately billing patients and payers for services they perform. The medical billing process can...

HHS, DoJ Announce Largest Healthcare Fraud Takedown

by Jacqueline Belliveau

The Department of Health and Human Services (HHS) has recently partnered with the Department of Justice (DoJ) to charge 301 individuals, including 61 physicians and licensed medical professionals, with reportedly participating in healthcare fraud...

OIG: Provider-Based Status Leads to Improper Medical Billing

by Jacqueline Belliveau

The Centers for Medicare and Medicaid Services (CMS) could reduce improper medical billing by eliminating provider-based designations or equalizing payments for the same services provided at different care sites, according to a recent report...

74% of Providers See Increased Patient Financial Responsibility

by Jacqueline Belliveau

A recent report from InstaMed found that 74 percent of healthcare providers reported an increase in patient financial responsibility in 2015, which has prompted healthcare revenue cycle management strategies to focus more on consumers. “With...

GAO: Backlog Persists for Claims Reimbursement Appeal Process

by Jacqueline Belliveau

Discovering that a claim has been denied is hard enough, but the appeals process that manages claims reimbursement disputes may be even harder to handle for most healthcare providers. According to a recent report from the Government Accountability...

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