On July 1, a CMS rule requiring prior authorization for certain hospital outpatient procedures goes into effect. The rational for why CMS is instituting this change is summarized below.
Reducing hospital readmissions has been a longstanding goal for most health systems and the Hospital Readmissions Reduction Program (HRRP) formalized this goal by creating incentives (and penalties) for reducing readmissions for certain diagnosis. Now w [...]
While each health center is in varying stages of the COVID-19 battle, one underlying goal is on all our minds – how do we safely re-open our facilities to patients who need in-person care?
COVID-19 continues to disrupt every aspect of the healthcare revenue cycle landscape and, as a leader, you need to maintain awareness of countless regulatory adjustments, but also the broader impact on your employees and patients. In the billing space [...]
Have you recently found yourself with a partially or fully remote team? Are you looking for ways to engage and communicate with your team members? If so, virtual huddle boards may be the solution you are looking for. As a former Patient Access Director, [...]
COVID-19 seems to be bringing about day-to-day and even hour-to-hour changes to your operations as both best practices and regulations are adjusted. In Part One of our deep dive, we talked about best practices you can implement now to help you continue [...]
A belated Happy Patient Access Week to all the Patient Access professionals working on the front lines of our healthcare system! Your work to facilitate patient communications, provide safe and efficient access to your organizations, and drive the [...]
As we all navigate uncharted waters with this unprecedented pandemic, we are working to identify best practices and considerations specific to the revenue cycle. While we continue to see variation around billing guidelines from payers, the following list [...]
A point of pride for The Wilshire Group is sharing our lessons learned with the community at large – whether you are a present, past, prospective customer or a healthcare system working to adapt to the changes facing us all right now.While the darkness [...]
It’s hard to overstate the disruption that our nation is experiencing from both personal and business standpoints. One of the most significant changes is the mass exodus of workers from the office to the home. Different employers have different [...]