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Collections: Tame the beast

Q. How can I get organized to realize potential patient revenue?
 - 
10/25/2013

A. Turning your potential revenue into actual revenue is looked at as something scientific and difficult to achieve. In all actuality, it needs to be managed individually like any other department.

Legal: Evaluate HIPAA compliance program

Q. Can a person or entity sue for a HIPAA violation?
 - 
10/25/2013

A. Generally, no. HIPAA requires covered entities to maintain the confidentiality of patients’ medical records and other protected health information.

Audits: Appeal early, appeal often

Q. Is it better for me to wait to file my appeal and group my appeals together?
 - 
10/25/2013

A.

Valuations: Weigh pros, cons before partnering

 - 
09/24/2013

Q. What are the major considerations in determining the benefits of entering into a partnership/joint venture with a hospital-based HME provider?

Collections: Educate staff, patients

Q. Should I review and audit our intake and documentation processes?
 - 
09/24/2013

A. Proper communication and training  between staff and patients is crucial at intake to ensure documentation is completed. 

Legal: Don't forget about HIPAA changes

Q. Should I be concerned about HIPAA changes?
 - 
09/24/2013

A.

Audits: File quickly on appeals

Q. Is it worth appealing a denial from the RAC or ZPIC auditor?
 - 
09/24/2013

A. With the increased audit activity over the past year, appealing overpayment determinations is necessary to avoid recoupment and keep your head above water. 

Know the timelines

Valuations: Look at five year projected cash flow

Q. How do I calculate a fair market value and reasonable purchase price for a contracted supplier?
 - 
08/23/2013

 A. If you are purchasing the entire company, of which the bid contracts are part and parcel, then you will need to value both the existing business and the incremental cash flows the business will generate as a result of having won a bid contract(s).  

Collections: Gather true AR picture

Q. How do I determine whether outsourcing patient collections is right for my company?
 - 
08/23/2013

A. To determine if this is a true need, the provider must become familiar with patient balances at that moment to include accounts receivable buckets in detail and know the acceptable percentage in each.

Legal: Don't run afoul of supplier standards

Q. What are some of the rules subcontractors must follow?
 - 
08/23/2013

A. For the past several months, DME suppliers have been calling me with questions concerning the interplay between contractors and subcontractors in Round 2 of the competitive bidding program (CBP).

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