At least $1.5 million were gained by most of the hospitals in healthcare revenue after clinical documentation improvement (CDI) implementation, a Black Book survey discovered.
In accordance to Black Book Market Research, almost 90% of hospitals with 150 or more beds and outsourced clinical documentation functions recognized at least $1.5 million in suitable healthcare revenue and claims reimbursement following clinical documentation improvement (CDI) implementation.
You might be unaware of the risk that your Medicare collections and Revenue could be at Danger. The loyal staff has mentioned that a recurring trend during analysis of customers’ Accounts Receivable. The claims being refused by Medicare for benefit non-coverage during the research of Medicare Part A or Medicare Part B Balances because of a patient being enrolled in a Managed Care/HMO/PPO plan that has replaced the Medicare Part A or Part B Benefits or vice-a-versa.
The matter of concern is that how can you stop this from happening in your facility and be certain that the suitable payer is being recognized and billed in a timely way?
The answer involves using a very basic and simple procedure including Medicare Eligibility and the Common Working File. We suggest that the Business Office Staff or an assigned staff member complete a Medicare Eligibility Benefit check, referred as the HIQA/MECCA check, utilizing the Medicare Direct Data Entry (DDE) System, to verify a resident’s present Medicare Eligibility status. At a minimum the HIQA/MECCA check should be implemented for each of the following cases: