Advent Health Partners

Recent Posts

How to Reduce Denials More Efficiently and Maximize Revenue with Technology

Posted by Advent Health Partners on Nov 14, 2017 9:30:00 AM

At Advent, we constantly affirm the importance of standardization. Through deploying common processes and language across departments and facilities, hospitals can improve efficiency and reduce the chance (and often, inevitability) of human error. In today’s healthcare landscape, the easiest way to implement standardization and efficiently manage administrative processes is through a technology-based approach.

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4 Steps to Win More Appeals, Reduce Denials, and Improve your Bottom Line

Posted by Advent Health Partners on Nov 2, 2017 9:30:00 AM

The American Medical Association found payers return up to 29 percent of claim lines with $0 for payment, while a MGMA study found more than half of denied claims are never reimbursed.  Because the American population is aging and requiring more and more care, healthcare providers are often having to transition patients across different/multiple setting and specials - requiring multiple claims. As a result of these factors, complexity increases.

If providers can begin closing the documentation gap that leads to medical necessity denials, your organization will see a positive impact on your bottom line as well and patient care and satisfaction.

Healthcare providers everywhere are striving to answer this question: How can we better manage denials?

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4 Common Challenges in EHR Implementation

Posted by Advent Health Partners on Oct 19, 2017 9:30:00 AM

Since the initial implementation of EHR incentive programs in 2009, 73 percent of eligible providers in the US have registered. Although many of these changes to record management have been successful, sometimes on boarding and adoption isn't always easy.

Dedicating the time, resources, and cooperation across an entire organization can be difficult... especially while continuing to run standard operations. In our experience, besides cost, it's among the primary objections for adopting an EHR.

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How to Prevent the 4 Most Common Medical Billing Denials

Posted by Advent Health Partners on Oct 10, 2017 9:30:00 AM

In healthcare systems, average medical billing denial rates range from 5-10%, with better performers averaging 4%. Some organizations even see denial rates as high as 15-20%.

The good news is, many medical billing denials can be avoided. Reducing denials even by a fraction of a percent can have a substantial impact on your organization’s bottom line.

If your organization is able to understand the different types of medical billing denials, pinpoint the most common billing problems and take steps to avoid them, you could collect more of what you deserve and transform your bottom line. Here’s how to make it happen:

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Appeal Letter Best Practices for Providers to Overturn More Denials

Posted by Advent Health Partners on Oct 4, 2017 9:30:00 AM

When defining medical necessity, most payers base their payment off of evidence-based medicine and guidelines of appropriate medical care by the appropriate healthcare provider.  

Some health coverage denials, such as when a healthcare provider enters a wrong code on a claim form, are simple mistakes that easily resolved. But there are other issues can be much more difficult - centered on complex medical questions like whether a certain medical treatment is appropriate. Battling health insurers when they refuse to cover certain treatments can be exasperating, time-consuming and costly. But, through a disciplined denial management program, providers can fortify their cases and better address complex denials.

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How Provider Utilization Management Reduces Costs on the Front End

Posted by Advent Health Partners on Sep 11, 2017 3:52:30 PM

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With the majority of Americans now enrolled in privately or publicly funded health plans that use utilization management (UM) programs as a primary cost-containment strategy, it has never been more important for hospitals to follow a process that is clinically sound and routing patients accurately/efficiently than now. Becker’s highlights utilization review as a key component of leveraging case management best practices with the revenue cycle, which paves the way for improved workflows.

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Top 4 Ways to Reduce and Manage Medical Necessity Denials

Posted by Advent Health Partners on Aug 22, 2017 1:30:00 PM

With more insurance and governmental regulations increasingly tightening claims payouts and other changes faced by hospitals and physician offices, good claims management and reducing the potential for denials is more critical than ever, with the average cost of reworking claims estimated at $25 per claim. Here are four key areas to watch for reducing denials while increasing revenues:

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5 Best Practices for Health Insurance Appeal Letters

Posted by Advent Health Partners on Aug 15, 2017 1:30:00 PM

Although most hospital administrators know that lost revenue is a problem, they may be unaware of just how much of it is due to claim denials. While it's critical to optimize your claims-management processes to minimize the number of denials in the first place, some denials are inevitable. In these instances, revenue cycle managers and their teams can use the following strategies when preparing health insurance appeal letters to increase the possibility that denials won't result in write-offs.

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3 Ways to Improve Your Clinical Appeals Success Rate

Posted by Advent Health Partners on Aug 9, 2017 2:30:00 PM

Hospitals and other healthcare providers are using substantial amounts of resources and losing money from costs and inefficiencies within their revenue management cycles. The AMA estimates that as much as 25–30 percent of national healthcare expenditures are directly due to these transaction and related costs, with up to 15-20 percent of submitted gross charge claims being denied by payers. Given that the industry standard of expected denials is in the 3-5 percent range, anything significantly higher is cause for concern.

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Valuable Insights Healthcare Providers Need to Know in 2017

Posted by Advent Health Partners on Jul 25, 2017 4:50:05 PM

There’s a massive amount of content out there for healthcare providers to gain insight into pertinent topics. To ease the headache of searching, we have compiled a list of resources that providers have found most valuable and relevant in 2017.

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