Arizona Health Care Cost Containment System (AHCCCS)’s Post

As a part of our Medicaid Equity Monitoring Tool project, we have published a report on the data scan we performed, searching for qualitative data on Medicaid member experience. The report explains the data scan's process and findings to help us understand what data exists to populate a potential Medicaid equity monitoring tool, and to examine what qualitative data collection methods are used by various sources. We’ve also included a detailed appendix table that: - aligns each source to relevant measurement domains (e.g., accessing needed services, member-reported health and well being, etc.) - provides quotes from either Medicaid members themselves or their representatives - includes population demographics such as race/ethnicity and geographic location, among others Top-level findings reveal that there are few sources documenting qualitative data collection methods regarding the experiences of Medicaid enrollees – our scan found just 21 – even fewer that focus specifically on our project’s populations of interest, and even fewer studies conducted over extended periods of time. More on the details of our findings, our process, and the comprehensive appendix table in our report can be found at the link below. https://lnkd.in/gyvNrxaA You can also find our first report on the quantitative data scan for Medicaid member experience here: https://lnkd.in/eppMRUFi #medicaidequity #healthequity #medicaidequitymonitoringtool #SHADAC #medicaidmemberexperience #medicaidexperience #publichealthequity #medicaid

AHIP's latest report sheds light on the increasing popularity of Medicare Supplement plans among fee-for-service Medicare enrollees. 41.4% opted for these policies in 2022, and more than half chose them in 2021, making it essential to understand the demographics and financial benefits of such coverage for making informed decisions. https://b .ly/3UNy5pv Healthcare Finance News #HealthPlans #payments

Lab billing denials are caused by inaccuracies in patient demographics, eligibility and coverage issues, incorrect or incomplete coding, and missing required documentation. Learn how to reduce these common errors and stop lab revenue leakage. bit.ly/3BLV9IH #lab #billing #RCM #pathology #healthcare #revenue

Reduce Denials & Boost Revenue! 💰🔬 I just shared an insightful article that dives into how labs can effectively reduce denials and increase revenue with advanced LigoLab RCM solutions. Discover key features like: ✨ Automated Claims Management: Say goodbye to denials! 📊 Real-Time Analytics: Track your revenue and optimize performance. 🔗 Seamless Integration: Easily connect with your LIS and billing systems. If you're looking to streamline operations and maximize profitability, this article is a must-read! 🌟 Subscribe for the latest insights and stay updated on tools that can elevate your lab’s success! #LabTech #RCM #LabOperations #HealthcareInnovation #LIS #LigoLab #Laboratory #Efficiency #RevenueCycleManagement 🩺📈

Medicare Advantage and the potential end of the "gold rush" has been all over the headlines recently. It is true, the market is evolving quickly. Yes, many of the headwinds are real. But it's important to not lose sight of the important role Medicare Advantage products play improving access to care across our communities. A couple of key highlights from the AHIP 2024 Medicare Advantage Demographics Report: 38% of MA enrollees have annual income less than $25,000; 54% of enrollees from diverse populations pick MA; and 85% of MA enrollees come from urban settings. Ultimately, if the long-term goal is to slow Medicare Advantage growth, it has downstream impacts that shouldn't be ignored.

Do you check all patient demographics when you book an appointment outside of eRS? When you add a patient to a waiting list or book a patient outside of eRS how do you do it? Do you copy the NHS number from eRS and put it in your Trust's EPR/PAS? If the NHS number is found, how much of the patient's details do you check? Do you check all these? ●Forename ●Surname ●Date of Birth ●Address ●Telephone numbers I would guess that you check the names and date of birth because they are easily available from where you have copied the NHS number, but do you check Address and telephone numbers? These are just as important to check as if you are sending a letter to the patient with an appointment or telephone them, do you have the latest information? Next time you book a patient outside of eRS or add them to a waiting list, make sure you check all the patient's details. #18weeks #healthcareadministration #medicalsecretary #nhscareers #training #seniormanager #trainingcourse #hospital #NHSJobs #nhs

“Admissions - ER Live Support” estimation revenue generation, demographics correction program.    We can be engaged the program one of 2 ways: 1. Off the provider's EHR Estimation platform. We are actively familiar with many host EHR’s and can be brought up to speed quickly. A. Your associates would get 1st crack at it, we pick up any patients missed and communicate post patient clinical services / EMTALA in setting up payment arrangements through direct communication; phone, text, email.           B. Correct any erroneous information. This in the beginning has been the unrealized benefit. We have reduced error-ed billing and more claims being paid on the first pass.   2. Incorporate VestaPay’s estimation platform if the estimation platform is not included in the facilities EHR. following the A & B above protocols.   Again, our primary goals are; 1. Setting of payment arrangements, right after services and EMTALA. 2. Corrective demographics / updated insurance information – reducing rejected claims. Claims paying on the 1st pass. 3. Improved customer relations.   This program will have a positive impact on your daily cash flow as well as timely claim reimbursement. Additionally, our Patient Engagement Workshops will be included. The Patient Engagement Workshops on its own will increase your associates’ first crack success.   Open to a call on this? Q and A? 

#credentialing #providerenrollment #chiropractors #ushealthcare #Medicalbilling PAR or Non-PAR? Which Option is Right for Your Practice? When deciding between participating (PAR) and non-participating (Non-PAR) provider status, it's essential to consider various factors. Participating providers accept assignments, with patients only paying deductibles and co-insurance upfront, while Medicare reimburses the allowed fee later. On the other hand, non-participating providers can collect full fees from patients, partially reimbursed by Medicare, and can collect upfront payments for non-covered services. There's no universal answer - the best choice depends on your practice, patient demographics, and financial objectives. Understanding these differences will help you make an informed decision.

Accurate patient demographics are the backbone of effective medical billing. Ensuring that all demographic information is correct and up-to-date can prevent numerous billing issues, from claim denials to delayed payments. For small practices, the accuracy of data such as patient names, addresses, insurance details, and contact information directly impacts the efficiency of the billing cycle. #PatientDemographics #MedicalBilling #SmallPractices #HealthcareEfficiency

Good Afternoon, #Healthcare Family...!!! Here comes the chapter 2, of our #Learning the core of #HealthcareFinances with Remini RCM. First Step in the #RevenueCycleManagement: “Patient Registration and Pre-Authorization” The RCM process begins with #PatientRegistration, during which demographic and #Insurance information is gathered. This step is essential for creating accurate #PatientRecords and verifying insurance coverage. For specific procedures, #PreAuthorization may be required, ensuring that the payer approves the services before they are provided. Please visit and follow Remini RCM for more information or call us now for #FreeConsultation at: (415) 625-6365 #Staytuned #ReminiRCM #PatientHealthInformation #PHI #InsuranceVerification #PatientDemographics #ElectronicHealthRecord #HIPAACompliance #MedicalBilling #AccountReceivables #PracticeManagement #RCM #HealthcareInnovation