The concept of getting the biggest pay-off for the least work isn’t a new one — and the phrase “going after low-hanging fruit” has been around since the writer P.J. Kavanaugh coined it in 1968. Most likely, Kavanaugh wasn’t talking about financial operations for healthcare organizations, but it’s still an important lesson in with today’s complex, 100-miles-per-minute revenue cycle.
Medical necessity edits are a great example of what could be your revenue cycle’s low-hanging fruit. Ensuring your Medicare claims are in compliance with the National Correct Coding Initiative (NCCI), local medical review policy (LMRP), national coverage determination (NCD), and local coverage determination (LCD) can be a quick and simple task Or conversely, it can be tedious, resource-sapping work.
By automating medical necessity edits, you can simplify a revenue-generating process—and remove potential bottlenecks, avoid lengthy appeals, and reduce write-offs. Consider how these tasks would help your billing office:
- Flags procedure codes that don’t have supporting diagnosis codes
- Ensures all necessary diagnosis codes are present prior to submission
- Increases staff’s awareness of ever-changing guidelines and helping you stay compliant
- Let you know when patients will need to pay costs not covered by Medicare
Would your revenue cycle benefit from low-hanging fruit? If so, contact a Waystar client sales representative at (877) 628-4287, or by filling out this form to learn more.
