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M.E.A.T. CLINICAL DOCUMENTATION HOW TO
M.E.A.T. CLINICAL DOCUMENTATION UPDATE
M.E.A.T. CLINICAL DOCUMENTATION REGISTRATION

Having fewer problems and denials leads to less time spent on resubmissions and appeals - time that could be spent on other important operational processes.

Improving accuracy and efficiency translates to less time spent on RCM.

Having complete patient health records with accurate identifying information, diagnosis and service codes, physician’s notes, and other documentation helps ensure that your organization consistently delivers a high standard of care.

Optimizing revenue cycle management is important not only for a healthcare organization’s financial health but also correlates closely with several other key organizational imperatives: Most pointedly, the top reasons cited include a lack of experience and expertise on the part of healthcare staff, staff attrition and shortages, a lack of training and education, a lack of RCM strategy, and difficulty keeping up with regulatory changes - problems that a robust clinical documentation integrity (CDI) program can help eliminate. To add further urgency to the problem, Change Healthcare found that denials rose each year from 2016 through the beginning of the COVID-19 pandemic in 2020. Two of the most sobering findings - that 86% of denials could have been avoided and nearly one-fourth of those were not recoverable - indicate that accurate clinical documentation is critically important to a healthcare organization’s bottom line.

M.E.A.T. CLINICAL DOCUMENTATION REGISTRATION

Notably, the analysis revealed that half the denials were caused by issues in the early stages of the revenue cycle - including registration, eligibility, authorization, and coverage - with registration and eligibility issues equating to nearly 27% of the total. affected by the highest first-wave COVID-19 outbreaks. Denial rates were even higher in areas of the U.S. How clinical documentation integrity affects revenueĪccording to the Change Healthcare 2020 Denials Index, in an analysis of 102 million transactions from over 1,500 hospitals valued at $407 billion, denials exceeded 11.1% of claims between 2016 and the third quarter of 2020.

M.E.A.T. CLINICAL DOCUMENTATION UPDATE

In addition, coding requirements, regulations, and medical billing systems are subject to change, requiring your new and existing staff members to update their knowledge and skills at regular intervals to avoid mistakes that can lead to lost reimbursements. Throughout the cycle, the possibility of errors looms if your staff isn’t up to speed on the complex coding demands and rules set by hospitals, insurers, and the Centers for Medicare and Medicaid Services.Įrrors can add up to a significant amount of lost revenue over time through claim denials, inaccurate or incomplete reimbursements, prior authorization issues, incomplete physician documentation, and incorrect coding.

Many participants have a role to play in the revenue cycle, and at each stage they must employ their specialized knowledge of how that patient interaction and service is documented in the patient’s health record.

M.E.A.T. CLINICAL DOCUMENTATION HOW TO

Your staff should know how to handle every element in the process accurately and efficiently, starting when a patient first accesses the system and ending when the account is paid. RCM is the set of functions that comprise the capture, management, and collection of patient service revenue in a healthcare organization. Poor revenue management can cause many organizations to struggle and experience financial difficulties or even disruption of services.

Without it, these organizations cannot survive. By Stacey Kusterbeck Revenue cycle management (RCM) is the financial process that makes it possible for most healthcare organizations to fulfill their mission of providing quality care for patients and communities.