Complex payment reforms, lower reimbursements, and mandates from the government can all lead to delays and denials in Medicare payments.
Medicare and Medicaid are a growing population segment, so timely and adequate payments from these organizations is a major problem for healthcare professionals. You can also seek help from the healthcare providers of CXC network via www.cxcsolutions.com.
Sometimes there may be technical issues, such as missing signatures in medical records, inconsistent spellings, or inaccurate data entry. Keep an eye on your denial tendencies to identify patterns early and treat them from cause or symptom.
The Affordable Care Act (ACA) made the transition from the fee for service model to the value based payment model. This is to improve healthcare services for patients and ensure that healthcare providers get paid according to the value of their care, rather than the number of tests or visits they perform.
Healthcare practices will need to reconcile the new model with the fee-for-service system. This changes analytics and metrics in order to make sure that costs are covered.
Revenue cycle management is also affected by the eighty-five per cent of patients who have received an advance tax credit for premiums under ACA rules. They have a grace period of 90 days to pay any outstanding premiums before they can be canceled by their insurer.
All consumers who have purchased subsidized coverage under the Affordable Care Act , health insurance market, are subject to this rule. This could cause problems in the tracking of patients and late payments. As part of your registration, check if your patient has paid their premium.