Many business offices, working toward an optimally efficient, cost-effective claims process, set a Clean Claim Rate (CCR) goal of at least 95%. A high CCR means less time and expense associated with getting accurate charges billed as soon as possible following the discharge of services.
Claim processing rules are the power behind your cash flow. The tool you use for scrubbing and submitting your claims is only as good as the library of claim edits under the hood that will identify errors before you submit – giving you the opportunity to send clean, error-free claims.
Movement continues on CMS reimbursement of Advanced Diagnostic Laboratory Tests (ADLTs) and Molecular Pathology testing during the 14 days following a hospital stay.
When it comes to healthcare claims, cleanliness is next to, at the very least, fiscal fitness. Producing claims that are “clean” and therefore immediately reimbursable is an important factor in reducing cost-to-collect, especially in an environment where the growth of costs (7.5%) are outpacing revenue (6.6%).[i] While some denials are inevitable, reducing your denial exposure is all about [...]
Automation is more and more important in today’s patient financial services office. Shrinking margins dictate smaller teams, while the complexity of achieving reimbursement only increases. In that environment, being able to rely on advanced, highly-automated technology is essential for your efficiency…and your sanity.