by Jason Anderson | Oct 3, 2018 | Healthcare Appeals, Healthcare Reimbursement, Hospital Reimbursement, Hospital Revenue Cycle
When Maryland hospitals attempt to discharge a fee-for-service Medicaid recipient to a lower level of care but are not able to, they may want to be reimbursed for “administrative days.” These are days of care for a patient who no longer needs acute inpatient care but...
by Chris Thibeault | Dec 3, 2015 | Appeals and Denials, Healthcare Appeals, Healthcare Reimbursement, Healthcare Updates, Hospital Reimbursement, Hospital Revenue Cycle
Medicare’s Consolidated Billing Rules for Home Health Beneficiaries Apply to Hospital Claims. In reviewing denied claims referred to our office, it is my experience that hospitals must be aware of Medicare’s Consolidated Billing rules when providing services to home...
by Gustavo Matheus | Jul 28, 2015 | Healthcare Reimbursement, Healthcare Updates, Hospital Reimbursement, Hospital Revenue Cycle, Managed Care Reimbursement
Most health plans have contracts with hospitals that require billing within 180 days of the date of service. Some self-insured plans allow hospitals to submit their bills for up to a year. There are strict statutes in place to ensure these billing deadlines are...
by Gustavo Matheus | May 26, 2015 | Healthcare Reimbursement, Hospital Revenue Cycle, Managed Care - General, Revenue Cycle Management
Doctors and hospitals continue to lose significant revenue because of legal barriers to reimbursement built into their provider contracts. When healthcare providers, whether large healthcare organizations or individual medical practitioners, join a managed care...
by Gustavo Matheus | Mar 24, 2015 | Healthcare Reimbursement, Hospital Revenue Cycle, Managed Care - General, Medicaid Reimbursement, Revenue Cycle Management
When Injured Patient Arrives at ER, Hospital Managers Must Prepare for Interpleader Lawsuit, Seek to Recover Unpaid Medical Bills. From the moment a patient injured in an accident arrives at the emergency room, hospital administrators, emergency staff, and admitting...
by Gustavo Matheus | Oct 28, 2014 | Hospital Revenue Cycle, Managed Care - General, Payer Reimbursement, Probate
by Ron Landsman, Esq. – Guest Contributor Note from Gustavo Matheus: When dealing with high-cost medical cases, oftentimes hospitals lose significant revenue simply because they fail to create special needs trusts. Since such an omission results in many missed...
