ICD-10: The One-Year Mark, and Preparing for End of Grace Period

Happy anniversary! Or perhaps we should say congratulations for making it through the first year of ICD-10.RemtiDATA_Comparative_Analytics_ICD10_One Year

If your organization reflects what our data is revealing, the past 12 months have likely been relatively uneventful. Taking a look at our data, we are continuing to see a steady decrease in claims processing and payment velocity. Reviewing average processing time from October 2015 through September 2016, we are noting that processing time is down.

And yet, by the time you read this blog, we’ll be well into October, the grace period for getting the correct code will have ended. As you are likely aware, the Centers for Medicare and Medicaid Services (CMS) stated that it will not extend the ICD-10 grace period beyond October 1, announcement released in August.  When ICD-10 went live in 2015, CMS said it would not deny claims as long as healthcare providers used codes in the correct "family" related to the treatment. This is now changing.

Claim denials, already one of the largest areas of lost revenue for healthcare organizations, have even greater potential to ...

more

Happy 90th Anniversary, MGMA!

We are now less than a month away from MGMA. And what better way to celebrate MGMA’s 90th anniversary than in the beautiful city by the Bay.

Let’s think about how far the medical field has come in the past 90 years. We are innovating in areas of medicine, treatments and medical technology at lightning speeds, taking medical care to unprecedented levels.

Innovation is also occurring on the administrative side, and to be more specific, in revenue cycle management. That’s why, at RemitDATA, we believe in the power of comparative analytics.  We innovate and develop comparative data solutions that help healthcare organizations compare their data to industry peers and help create benchmarks to improve revenue cycle performance and reduce medical costs of care.

We are consistently looking for ways to improve these solutions to help payers, providers and billing companies. This is where you come in.

When you get to MGMA, please be sure to stop by booth #1425 to take a quick survey so we can get to know YOU. What keeps you up at night?  And share your biggest business ...

more

Pokemon Go: There’s an ICD-10 Code for That?!

RemitDATA Comparative Analytics ICD-10

 

It’s been all the rage this summer. Unless you’ve been living under a rock, you know what we’re talking about: Pokemon Go, the most successful mobile game ever in the U.S. based on peak daily active users. The busiest day for Pokémon Go in the U.S. was likely July 14, when SurveyMonkey estimated that just over 25 million smartphone users played the game.

The nature of the game, which combines GPS and augmented reality, means providers will see, or have already seen, a growing number of Pokemon Go-related injuries, ranging from broken bones to headaches. As such, providers better be ready to provide the closest corresponding code when submitting claims for payment. And, with the October 1 end of grace period for ICD-10 codes looming, it’s important to get your codes right….or risk having your claim rejected.

These are just a few to consider. Be sure to consult your ICD-10 code book for more specific code needs.

more

The Powerful Combo of BI Solutions and Comparative Analytics

We are lucky to be operating in a world where data and intelligence are readily available…at our fingertips. It makes all of us more accountable, and gives us the ability to deliver reliable results to healthcare organizations looking for ways to be more profitable and more productive.

That said, there are two types of data solutions that can help you define your future:

  1. Business Intelligence Solutions
  2. Comparative Data Solutions.

Although the differences might seem subtle, it is important to understand those differences.  An organization needs to ensure that their BI solution has comparative analytics and/or can align with a comparative analytics solution.

To be clear, Business Intelligence (BI) is a term that encompasses all knowledge we seek – current and historical business data that helps you to achieve a solid outlook.

Comparative analytics takes business intelligence to another level, building upon the concept of BI, taking data a step further by enabling an organization to compare the performance of their data to that of their peers.

Combine the two and… be...

more

ICD-10: June Year-Over-Year Report

While we presented the mid-year report card which included June 2016 data based on date of service, we thought it ICD-10 Healthcare Comparative Analytics - Request more info
would be interesting to compare June 2016 with stats from one year ago, based on check date. This will illustrate
how the industry is doing based on claims processed in June. Here’s what we found:

In almost every category – from DME to procedures and imaging – the denial rates were down from June 2015.
July_2016_ICD_Service_level_RemitDATA_Comparative Analytics

Processing time: this category was especially of interest, as our data is reflecting an overall reduction in staff processing time.
Payers are processing claims 3 days slower this year than in 2015, but staff processing time is 5 days faster.
In almost every category – from DME to procedures and imaging – the denial rates were down from June 2015.      
July_2016_ICD_processing_RemitDATA_Comparative Analytics

Remittance velocity: Another interesting find, in that claims are being paid faster during June 2016 than during June 2015
– with only 16.3% reaching into the 61+ category.
July_2016_ICD_remittance_RemitDATA_Comparative Analytics

The data continues to be of interest, as one would assume ICD-10 to slow things down.
But, important to note that the year ...

more

Revenue Cycle Management is a Top Challenge for Healthcare Practices

Data is our business. Well, it’s the focal point of our business. We believe data, whether primary research focused, aggregated or anecdotal helps any business make empowered business decisions.

Naturally, we look to data to inform our own business, which is why the survey we conducted among providers, RCM companies and healthcare vendors was so beneficial.

From that survey, we were able to aggregate and report some key findings on the four biggest concerns among healthcare organizations. For example, nearly half of providers (41 percent) cited acquiring new patients and competition as a top concern. More than 50 percent of RCM companies and vendors reported acquiring new customers as a top challenge.

Want to know more? Becker’s Hospital CFO published an article on these key findings from our survey. To learn more, click here.

more

NEW Claim Level Detail Reports in TITAN

It is a common practice among health plans to review claim level detail when working with 835 data. Providers can now get this same level of information straight from the 835 file, and get a complete view of claim level detail and related adjudication information.

We are proud to announce that this new capability is now available in TITAN!

Here is the low down:

Currently in TITAN, all metrics are based on service line detail. With the addition of claim level detail, you now have access to more metrics along with the service line information you have become accustom to monitoring.

New Reports Based on 835 Metrics include: 

  • Average Claim Processing Time Analysis: Analyze claim counts vs. service line counts to track patterns and reveal issuesClaim Average Processing Time Analysis
  • Claim Denial Analysis – Identify and track denial trends at the claim levelClaim Denial AnalysisClaim Denail Analysis 2
  • Claim Dollar Overview – Determine which payers have the highest or lowest billed amount per claimClaim Dollar Review

These new claim level reports give you access to the following features.

  • New filters including: claim status and claim filing indicator
  • New query logic, such as...
more