Fall brings vibrant colors, homemade chili, championship baseball – and new CMS regulations for reimbursement! In reviewing upcoming changes for 2018, here are five takeaways that wound centers need to be aware of.
Billing and coding is a topic that is constantly changing in outpatient wound care. Ruth Stevens the vice president of Revenue Cycle at Wound Care Advantage recently wrote an article titled 9 Tips for Improving Your Hospital’s Wound Care Billing and Coding Performance for Becker’s Hospital Review. The article reviews real tactical tips to … Continued
Hold on to Toto, Dorothy, the winds of change are here, and it looks more like a tornado than a gentle breeze. This week, CMS published their proposed changes for OPPS, (Outpatient Prospective Payment System, which provides the rulebook on how outpatient provider based centers, which wound centers usually are, get paid) which was first … Continued
One of the frustrating issues our team often comes across when we help hospital partners transition from being with a management company to owning and controlling their own program, is the lack of correct billing, coding, and collection processes we find. More frustrating than finding these issues is often times the battle we need to … Continued
A recent article in Health Leaders Media by Philip Betbeze, discusses the need for hospitals to be profitable based on Medicare reimbursement. We passionately feel that the same should be said of Wound Centers. For over ten years, I have believed that a wound center must be able to provide a strong margin on Medicare … Continued
For over a decade one of the most focused on terms in hospitals was “length of stay”, or LOS. This term identifies how long a patient is in a bed as an inpatient. With the introduction of DRG’s, how long a patient was admitted had a significant effect on the revenue for a hospital. Now … Continued
About ten years ago I was presenting our wound program management model to the executive board of a California hospital. When I was finished, the CFO looked at me and very directly announced that we would not be a good fit since our financial bottom line was almost three million less than another wound center … Continued
When we receive calls or e-mails from hospitals with existing centers, the first question we hear is usually; “How much revenue should we be seeing?” With hospitals looking to build a new center, the question is most often; “How long until we break even?” Financials are a vital part of any out-patient wound care program. … Continued
Holy Mackerel! Do you realize that in less than two weeks, two “final rules” have been released by the US Department of Health and Human Services which will have more of an impact on the entire hospital industry than all of the final rules released in the last ten years combined? OK, that could could … Continued
One of the most concerning aspects of out-patient wound care billing over the last several years has been the use of E&M codes, (Evaluation and Management codes which are billed when a physician and team meet certain criteria) and when they can be used. Recently, Norton Healthcare in Louisville, Kentucky had paid the federal government … Continued