Provider burnout is an ever-increasing problem, and employees across the healthcare industry are overworked and overburdened. The prevalence of EMRs has led to a daily deluge of bad electronic billing data, and RCM teams can struggle to keep their heads above water. Luckily, there are better ways to manage this workload—without increasing provider burden.
In this free eBook, we explain how the Revenue Cycle Engine enables you to transfer your knowledge into custom-built rules to address your payer requirements, specialties, value-based contracts, and more. Below are a few examples of the categories of custom rules we cover—download the eBook to learn more about how these rules combat the challenges facing RCM teams.
Patient History
There are many custom rules that fall under the patient history umbrella, including rules that identify new vs. established patients, rules that recognize the global period for every minor and major surgical procedure code and help to prevent denials, and rules that monitor frequency limitations.
Billing for Immunizations
Over time, our team has built out more than fifty rules related to administration and immunization code billing. These rules account for multiple factors including patient age (adult or pediatric patient), type of administration (for example, intranasal, oral, intramuscular, or a combination), Medicare requirements, counseling requirements, units of measure, number of components (each antigen in a vaccine), and more.
Billing for Telehealth
Keeping track of different payer rules for telehealth visits can be daunting, although requirements are more stable now compared to the early months of the COVID-19 pandemic. Within the Revenue Cycle Engine, many rules are delivered out of the box to automate review of telehealth charges.
Reporting of Quality Measures
The Revenue Cycle Engine can do more than support compliance with payer requirements. For example, it can also support reporting of quality measures.
Diagnosis Reordering
The Revenue Cycle Engine can help prevent denials by assuring CPT codes are in the correct position to support diagnoses.
For specific examples of these rules in action—and more—download the free eBook.
