Kona Medical Consulting’s Post

Are #SIU properly integrating #medicalrecordreviews by utilizing the proper staff for this work? This week, we take a deep dive into the important role these reviews have in the FWA payment integrity lifecycle. #ahla #hcca #healthcarefraud #healtcarecompliance

In assessing the financial health of a medical group, various indicators play a crucial role in determining its overall fiscal stability. Recognizing these key features is essential for identifying whether a medical group is encountering financial challenges. 📉💼 The following points outline several indicators that signify a medical group may be facing financial difficulties. 💸🏥 📉 Declining revenue. 💼💰 High operating expenses. 📈💳 Increasing debt. 📉💵 Low profit margins. 💸🔄 Cash flow problems. 📉🔄💳 Unfavorable payer mix. 🏥📉 Declining patient volume. 💰📈 High accounts receivable. 🚫💰 Limited access to capital. 📉💼💰 Insufficient reserves.

Join me at SIIA 2023 National Conference! Oct. 8-10 in Phoenix. Here is the session I am participating in: Gag Clauses and Fiduciary Responsibilities: Where’s Our Claims Data? Self-insured plan sponsors have long battled over the ownership of their participants’ claims data, which medical providers and owners of provider networks have routinely refused to share. While the Federal gag clause prohibition is now cemented in law, these same providers and network owners are still balking. Questions of fiduciary responsibilities for the plan sponsor and the owner of the provider networks are at the center of this debate. This panel will explore these issues, discuss recent litigation, and how to navigate claims accessibility. Registration is open: https://lnkd.in/e7A4EDss

So your #Invoices aren't getting paid by the CRO? Have you checked these fundamentals? A well documented invoice is critical to your success. And thank you to Clinical Research Payment Network and the @CRPNCentral channel for providing our sites with the information they need to be successful. Have you joined CRPN? Its FREE for sites and affordable for Sponsors. Contact us today to learn more about how we may help you. And please #Subscribe to @CRPNCentral today for the latest in clinical trial tips, tricks, and business practices. #CRPN; #CRPNCentral https://lnkd.in/g_9_KAnj

The reimbursement landscape for laboratories remains dynamic, undergoing constant changes. Ensuring financial stability and operational efficiency is paramount for laboratories navigating reimbursement challenges. Two common pitfalls are: 1️⃣ Failure to stay informed about coding and payer policy changes 2️⃣ Inadequate billing procedures Learn more about how the constantly evolving reimbursement landscape affects labs and best practices to navigate the changes. ⬇ https://hubs.li/Q02HZBR20

Our latest white paper explores the evolving role of DRG audits within the payment integrity ecosystem. We dissect industry drivers, restraints and challenges faced, and opportunities as we progress through 2024. Read the full piece here! https://lnkd.in/gREQdPYD

Complex codes and ever-changing regulations can make medical billing overwhelming. Good news – we're here to simplify it all! From coding accuracy to claims management, trust us to boost your practice's financial well-being. 💲 https://bit.ly/3s0kUlh

Today, the CFPB issued a Notice of Proposed Rulemaking (NPRM) related to consumer reporting of medical information. The CFPB also released a Fast Facts summary of the NPRM. The proposal would remove an existing Regulation V exception to the Fair Credit Reporting Act’s limitation on a creditor’s use of medical debt information, and it would amend existing exceptions for use of other medical information related to credit eligibility determinations. The proposed rule would also generally prohibit consumer reporting agencies from including medical debt information in consumer reports to creditors making credit determinations. You can access the NPRM and Fast Facts here: https://lnkd.in/e3mjY5AV

The consultation on the ABPI code is now open!! Make sure you get your ideas heard on addressing all those little niggles you have with the Code #PMCPA #ABPI #consultation #compliance

Does your PI program include DRG audits? Should it? Take a few minutes and check out our latest white paper!