Articles

Once the public health emergency is ended, providers will face a revenue hit; mitigating the revenue loss is essential.

CMS recently revised its quality outcomes methodology. CBIZ is here to assist.

Did you know that CBIZ KA Consulting Services (CBIZ) provides services for behavioral health organizations? Click here to find out how we could assist your organization.

CBIZ discovered an issue that was leading to an increase in Medicaid denials for several of our clients. Find out how we assisted our clients in reducing these denials and how our efforts helped lead to a state to rewrite an onerous regulation.

Medicaid Applicants Have Embraced CBIZ’s Virtual Eligibility Services

Telehealth continues to expand, but payers are starting to audit for compliance.

Medicare has released their Final Rules for 2022 regulatory changes.

CMS has issued much stricter penalties for non-compliance with pricing transparency regulations per the Outpatient Final Rule for 2022. This rule takes effect on January 1st.

DRG downgrades, also known as clinical validation denials (CVDs), have been affecting hospital revenues for a number of years. Recently, though, hospitals have been experiencing a significant uptick in the volume of the CVDs. The article outlines an approach to addressing the increase in CVDs.

NPI denials can be far more complicated to resolve than at first glance. Read more to find out why.

Data analytics are key to conducting a comprehensive and efficient coding audit.

Read real world success stories about how the CBIZ Virtual Eligibility Counselor was utilized to qualify two patients for Medicaid that would likely never had completed the application process otherwise.

Over-Utilization denials are like going to a restaurant, ordering dinner and eating it. And then when the bill comes, American Express decides that a desert wasn’t needed so they won’t pay the bill.  In this blog post our President Sam Donio talks about addressing why hospitals need to fight these denials.

With the rise of ventilation services, CBIZ’s assessment can help ensure that these high-dollar cases are being coded correctly.

This article will highlight some of the Biden Administration’s initial healthcare policy priorities.

What providers need to know about the upcoming telehealth audits.

Two stories that show CBIZ going above and beyond for our Eligibility clients and their patients during the pandemic.

How CBIZ helped a behavioral health organization utilize their new EHR and apply the 2021 E&M standards.

How Medicaid expansion states benefited in providing access to care over non-expansion states during the COVID-19 Pandemic.

Many organizations leave the task of ensuring compliance/evaluating performance of their contracts to automated contract management systems. Ultimately, do you really know what your contracted payers are actually paying?

The new 2021 E/M Rules have been in effect for a month; have you measured your performance?

Most Favored Nation (MFN) pricing for Medicare Part B drugs went into effect on Jan. 1 and will have a significant impact on many organizations. This article will explain key aspects of the new pricing rule.

How CBIZ assists Canadian hospitals with billing American insurance companies through charge capture.

E/M reimbursement is changing in 2021 for physician office visits. This article features many of the key updates for work RVUs and the Medicare conversation factor.

Ways to improve denial management.

This article details the importance of DRG validation for hospitals and evaluates the different approaches that hospitals can use for improving compliance and optimizing revenue.

Complying with the federal pricing transparency requirements

This article features innovative enhancements that hospitals are making post-COVID-19 to their patient registration process for Medicaid enrollment.

Ongoing monitoring of managed care contracts is essential to ensuring appropriate reimbursement.

This article will address the 2021 E&M reimbursement changes with medical decision making and the recording of time spent with patients.

Exploring discussions related to the changes of the Public charge rule and detailing potential impacts on Medicaid and Charity care programs.