Navigation Links
Encompass Collects an Extra $130k for Client after Medicaid Rule Change

Encompass Healthcare Data Solutions went above and beyond to collect approximately $130,000 on 9,000 claims for one of its clients after a recent Colorado Medicaid regulatory change. In May, 2018 the Colorado Department of Health Care Policy and Financing announced an update made to the rounding methodology utilized for anesthesia units and providers. The new regulation requires claims to be submitted in 15-minute increments. For example, an anesthesia procedure lasting 12-minutes would need to be billed as 15-minutes.

In order for claims to be adjusted to be accurately reimbursed, claims with dates of service prior to May 31, 2018 needed to be resubmitted to reflect the new rounding requirements. For one of its clients, initial estimates by the Encompass Revenue Cycle Management (RCM) Insurance Receivables team identified approximately 9,000 qualifying claims totaling $130k in additional revenue. Resubmission, rather than re-keying, was necessary to meet the new requirements.

Significant staff time was invested to re-coup the additional claim money for its client – 840 total hours, with each RCM Insurance Receivables team member devoting 20 hours per work week until the project was complete. The Encompass management team also faced a budgetary dilemma. If all $130k was collected for the client the RCM share of that was approximately $8,500. However, staff cost to resubmit the claims exceeded $15,000. In the end, the obligation remained with the client and Encompass readily made the decision to resubmit the claims knowing that the RCM team would actually take a loss on doing so.

The project was completed in 6 weeks – both ahead of schedule and, therefore, nearly at breakeven for the department. The complex revenue cycle management process commands a lot of attention – attention that would be better spent on your patients. Our team stays on top of coding compliance rules and evolving state and federal requirements to make sure its clients have peace of mind that every dollar earned makes its way back to your practice.

Take a Revenue Cycle Management Risk Assessment today Revenue Cycle Risk Calculator


Encompass is a medical management company serving the healthcare industry by providing customized services in IT, revenue cycle management, clinical quality management, credentialing, payer contract and payer enrollment, and human resources.

Read the full story at

Source: PRWeb
Copyright©2018 Vocus, Inc.
All rights reserved

Related medicine news :

1. The Glenholme School Announces Continuing Education Through An All Encompassing Summer Program for 2015
2. Altec Announces Evolution 2016, Inaugural Conference for doc-linkTM Customers and Partners Encompassing Product Roadmaps, Best Practice Use Cases and Extensive Training
3. Emily Richardson, MD, Encompass Medical Partners’ Chief Quality Officer, will be Delivering a MACRA/MIPS Deep Dive for Registries
4. Reach New Heights with Encompass’ Credentialing & Payer Enrollment Team at NAMSS 41st Educational Conference
5. NTC Extends CSR Efforts, Collects 273 Toys for Local Underprivileged Children in Conjunction with Marine Toys for Tots® Foundation
6. All Children’s Hospital Johns Hopkins Medicine Collects Spit for Study Aimed at Helping Cancer Patients
7. Collects and Updates Newest Millionaire and Quality Single Profiles on the Page of Millionaire Matchmaker Online Canada.
8. Dallas-based Park Cities Pet Sitter Collects Over $2,750 in Pet Supplies and Monetary Donations During Their 3rd Annual “SUV Stuff” Benefiting Angie’s Friends.
9. Dallas-based Park Cities Pet Sitter Collects $3148 in Monetary and Pet Supply Donations for Charitable Organization, Angie’s Friends.
10. Andersonville Fitness Boot Camp Collects Food for Chicago’s Hungry
11. RMACT Collects Over 800 Letters to Tell Congress Why Insurance Coverage for Infertility Treatment is Important, Delivers Them on Capitol Hill
Post Your Comments:
(Date:12/8/2018)... ... 2018 , ..., the nation’s most visited website for senior living reviews, ... to its list of top medical alert systems for 2019. The medical alert provider ... one of fourteen companies that qualified for the list based on its demonstration of ...
(Date:12/6/2018)... SAN DIEGO (PRWEB) , ... December 06, 2018 ... ... alongside Mike Wilson, Medicare Analytic Consultant Senior of Blue Cross and Blue Shield ... Measures are Interrelated” on Tuesday, December 11, 2018 at 2:15pm PT at the ...
(Date:12/5/2018)... , ... December 05, 2018 ... ... advancing patient and family engagement with the use of the Precision Virtual ... technology provides Children’s National’s world-renowned neurosurgeons and physicians with a never-before view ...
(Date:12/5/2018)... , ... December 05, 2018 , ... Since PermaLip™ ... ruptures. The implants are invisible to the naked eye, ensuring a natural look. “I ... and that there are no signs of implant visibility,” says Dr. Jessica Kulak, double ...
(Date:12/5/2018)... ... , ... You can now experience two cutting edge Oregon brands at the ... in the cannabis industry with several brands including Sticks and Cabana ... award winning , botanical terpene company that focuses on using terpenes from non-cannabis sources ...
Breaking Medicine News(10 mins):
(Date:11/29/2018)... ... 29, 2018 , ... More than 205,000 individuals have signed the 4th Annual ... significantly increase funding for type 1 diabetes cure research after spending on such initiatives ... An estimated two million Americans are affected by type 1 diabetes, and about half ...
(Date:11/28/2018)... N.Y. (PRWEB) , ... November 28, 2018 , ... Satin ... presented a donation of $2,400 to Hudson Valley Honor Flight on Sept 28th, 2018 ... recent sales incentive campaign and presented to HVHF by Kevin O’Reilly, Founder and CEO ...
(Date:11/28/2018)... WOODLANDS, Texas (PRWEB) , ... November 28, 2018 ... ... from Rigaku Corporation has been published and is available to view ... concentrating on single crystal X-ray diffraction, published by Rigaku Oxford Diffraction , ...
Breaking Medicine Technology: