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The Value of Best Practices in Revenue Cycle Management in Hospital Outpatient Departments (HOPDs) and Wound Care Service Lines

The business of wound care is constantly in flux and requires close monitoring and excellent, timely education of providers and billers/coders alike. Denials of insurance coverage and benefits often are due to errors in filing to insurance companies. Excellent revenue cycle management is the foundation for maintaining good customer service and good workflow monitoring of services and claims. Any variation from following the billing standards can amplify into more complex administrative problems, result in denials and therefore seriously affect the bottom line.

While correcting errors that cause denials (by analyzing the reason for the denial and training providers accordingly), excellent processing methods must be emphasized throughout the denial management process for claims that have been turned down. A timely resolution should be the mission of each incident of denial so that the payer understands their responsibilities as early as possible.  Setting up an efficient processing protocol reduces complexity and expenses making more predictable and earlier results in the bottom line.

As we see Medical Billing being more complicated with ICD-10  in place, there is an increasing need for a clear workflow integration of all services. Comprehensive Healthcare Solutions has been a leader in developing lean and efficient revenue cycle practices that stay on top of current changes and provide clear methods for compliance.

Comprehensive Healthcare Solutions makes revenue cycle management easy by our ability to perform regular chart reviews, billing and code audits. Comprehensive teaches providers how to document and bill compliant with local and federal regulations. We teach with integrity and ensure that the right interventions are offered to the right patient at the right time.

These practices are becoming even more valuable in a more competitive and regulatory environment. We continue to place best practices of revenue cycle management as the first foundation to our wound care and hyperbaric programs.


Karin Roemers-Kleven