EqualizeRCM Services’ (ERCM’s) suite of healthcare solutions utilize robotic process automation (RPA) to optimize our clients’ RCM operations. Our subject matter experts deploy RPA to drive efficiencies in resource utilization. By leveraging both our expertise, our international teams and our RPA, we blend the right mix of human and machine capability to capture more revenue for our clients at the lowest total cost of collections.
Readabout RCM Robots: Optimize and Improve RCM Operations
CMS has implemented the overarching criterion for E/M services which makes it clear that medical necessity is the driving force of the level of service assignment. Specifically, CMS states in their statement of overarching criterion, “It would not be medically necessary or appropriate to bill a higher level of evaluation and management service when a lower level of service is warranted. The volume of documentation should not be the primary influence upon which a specific level of service is billed.”
Readabout Evaluation & Management: CMS Overarching Criteria vs CPT/Documentation Guidelines
RCM experts at EqualizeRCM Services (ERCM) advise on the significance of monitoring an array of critical indicators. Using these vital pointers, ERCM’s suite of RCM solutions would not only help you in providing some actionable insights but also would propel your RCM performance to the next level.
Readabout Critical Indicators: Importance of Monitoring Revenue Health in a Physician Practice
Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is a law that transformed the Medicare payment system for physicians. MACRA shifts Medicare to a value based system, tying your Medicare payments to cost and quality performance by replacing the flawed Sustainable Growth Rate (SGR) physician fee update formula. The goal is to improve care for Medicare patients by transitioning the payment system from volume to value beginning in 2019. The Quality Payment Program policy through CMS will reform Medicare Part B payments for more than 600,000 clinicians across the country, and is a major step in improving care across the entire health care delivery system. Based on their practice size, specialty, location, or patient population, clinicians can decide how they want to participate in the Quality Payment Program. There are two models to choose from:
Readabout MACRA Explained: How to Succeed Under MACRA