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SSI claim denials management series part 3 of 3: Q&A with SSI Revenue Cycle experts regarding key strategies to help you and your organization make improvements in denials management
Now that you’ve read about the top five types of claims denials and the top two KPIs to keep a watchful eye on, SSI experts Lori Brocato and Kaylee House share key strategies to help you and your organization make improvements in denials management.
SSI claim denials management series part 2 of 3: What are the top five most common types of claim denials?
Eligibility related denials often result in a hard denial or one where you will not likely be paid and these include those related to coordination of benefits, plan coverage, incorrect plan code entry, maximum benefit exceeded, inactive coverage, or even member not found. These types of denials often stem from either the information not being obtained from the patient during preregistration or when they present at registration.
SSI claim denials management series part 1 of 3: Two important claim KPIs you and your organization should be keeping an eye on
Stopping denials from happening altogether, on the front end of your revenue cycle, is a much better strategy than managing denials on the back end. With an industry average denial rate of 5-10% and a clean claim rate of 90%, SSI provides industry insights about these types of denials as well as denial prevention strategies to help you improve.
The ability to use Direct Data Entry (DDE) into Medicare Fiscal Intermediary Shared System (FISS) has been around for decades and is still widely used today. Even with the proliferation of Electronic Data Interchange (EDI) transactions that can be used instead, users still use DDE to manually enter, correct, adjust, or cancel Medicare transactions in FISS.
Hospitals continue to struggle to regain baseline inpatient and outpatient volumes following the COVID-19 outbreak—and many anticipate that volumes won’t return to normal until July 2021, an American Hospital Association analysis shows.
This paradigm shift demands that hospital revenue cycle departments reimagine the patient journey with an eye toward self-service, highly transparent, highly digital interactions. In a post-COVID environment, price transparency isn’t just about compliance.
Telehealth visits could top 1 billion in 2020, with 900 million visits related to COVID-19 alone, a recent report predicts. But even as the Centers for Medicare & Medicaid Services broadens access to virtual care, navigating telehealth and e-visit reimbursement during the pandemic presents unique challenges for providers.
The SSI Group — a certified Health Information Handler (HIH) is happy to announce that all of our current providers can get their Additional Documentation Request (ADR) letters electronically (as eMDR) through SSI as their registered HIH.
Despite the initial capital investments and maintenance costs, healthcare artificial intelligence (AI), is here to stay and projected to grow rapidly in the coming years. Learn more about the industry outlook and how AI benefits providers and health systems, improve population health & reduces healthcare expenses.
When it comes to support for revenue cycle software and HIT solutions, how often can you expect a quick answer from a friendly, U.S.-based support representative? SSI’s Vice President of Client Services, Brian DeWeese, is proud to lead a team that offers top support to client health systems.