Medical fraud and abuse costs both the government and insurance companies billions of dollars each year. Some fraud and abuse is unintentional, but in other cases, it’s intentional and known to be criminal. When that happens, fines and lawsuits are filed, and sometimes, someone goes to jail. Almost daily there’s a news story somewhere about […]

Just like almost all businesses large enough to have employees pay someone to audit their businesses, hospitals sometimes need to, or should have, someone come in to audit their receivables process. It can involve looking at the charge master or how charges are captured, or a host of other things. This article is specifically going […]

A recent article by CNN titled ‘The older you are, the worse the hospital is for you’ was a bit over the top when it comes to elderly care while they’re in the hospital. Unfortunately, they did touch upon some issues that are very real and worrisome. Daniel Oines via Compfight The fact is that […]

After the identification, confirmation, and submission of claims to insurance carriers, aggressive followup is critical to the success of health care accounts receivables. Insurance carriers place the responsibility for getting claims to their office on the hospitals. Phalinn Ooi via Compfight Often claims are lost, delayed or misdirected. When that happens, for whatever reason, the […]

It’s time for someone to stand up for the patient accounting manager, supervisor, director, team leader,… whatever position you happen to occupy at this point, stand up and give yourself a pat on the back from me. If I could, I’d round all of you up and take you all out to lunch at a […]