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Ensure Financial Stability by Enhancing your Perioperative Program

See if this sounds familiar…your organization understands the importance of providing surgical services (65% of hospital revenue as generally reported[1]), and in fact, you cater to your surgeons and their requests. Strategic and IT initiatives that span [...]

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Harnessing Your Superpower(-ful Questions)

What's more powerful than the perfect answer? A well constructed and delivered question. Questions can empower employees, guide conversations, and help discover hidden issues.  There's at least one thing in common between top consultants, coaches, and [...]

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Data Filing and Dollar Collection: How to enhance your front-end payment collection process

Two weeks ago, we discussed general RTE optimization with Epic. Today, we will be doing a deeper dive into RTE and how it can impact front-end payment collection.

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Coordinate to completion: How to transform your referrals processes for better outcomes

Ensuring patients complete referrals and orders for specialty services is vital to the health of your patients and your organization’s financial health. Yet, according to the Medical Group Management Association, only 50% of referrals result in a [...]

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Optimizing Real Time Eligibility with Epic

Many errors in the revenue cycle can be attributed to not selecting the appropriate insurance plan during registration. One recent presentation at the annual NAHAM conference cited that 20% of registration-related denials were due to coverage and Real [...]

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Do I need a referral for that? Focus on Referrals and Authorizations for Big Returns

Referral and Authorization workflows are vital to the financial health of your organization. They can determine if, how, and when patients are seen for services, and if you are reimbursed for those services. Due to the variety of stakeholders required, [...]

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Mind the Gap: Bridging the Coder-Clinician Relationship for Gains

Here at The Wilshire Group, we take pride in bringing resources together and navigating multidisciplinary areas to achieve optimal workflow and revenue cycle results. Last week we provided some ideas around CDI (clinical documentation integrity), and [...]

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What’s the Hype?…Outpatient Clinical Documentation Integrity

In last week’s blog: Evaluation and Management (E/M) Essentials, we mentioned aligning coding educators with clinical build experts to support a foundation for accurate coding and charge capture success. Undoubtably, such an education and feedback [...]

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Evaluation and Management (E/M) Essentials!

Evaluation and Management (E/M) services are an everyday essential for physicians and non-physician practitioners. E/Ms account for nearly 70% of front-end charge capture process for professional billing.  Although outdated and overwhelming, the Centers [...]

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Don’t Fall Prey to ED Charge Capture & Coding Vendors

The modern Emergency Department is a crucial and fast-paced environment, providing care at high costs.  It is imperative to obtain full reimbursement of services, yet many EDs struggle to charge and code their accounts effectively.  As a result, vendors [...]

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