Balance the Burden of the No Surprises Act
The long-anticipated regulations prohibiting balance billing as set forth in the No Surprises Act were announced earlier this year and are scheduled to take effect January 1, 2022.
Learn how your organization can prepare to implement the operational practices necessary by downloading our report.
July 22, 2021
How Aetna’s "white-bagged" drug policies are putting your patients and your reimbursement at risk
White-bagging policies like Aetna’s present a number of issues for providers including decreased net revenue, increased cost associated with storing and preparing white-bag drugs, as well as increased statutory and regulatory compliance risk.
July 7, 2021
Three steps to establishing a successful Pre-Access physician liaison program (and why it’s crucial to do so)
Three steps to begin removing barriers and building an effective and proactive communications strategy between pre-access and referring providers.
July 6, 2021
How to resolve credit balances and improve patient experience using Epic automation
Epic’s self-pay credits redistribution and automatic self-pay refund requests features could save valuable staff time and enhance patient satisfaction.
June 17, 2021
Why saying “That’s not my job” can harm your career
In this blog post, Ensemble Health Partners Susan Milligan and Gwen Collins explore intricacies of how saying "That's Not My Job" can harm your career.
June 2, 2021
Three common mistakes hospitals make when implementing Epic
Three common ways healthcare organizations ignore operational readiness in their Epic implementation process.
May 24, 2021
New HHS Reimbursement Program Requires Scrutiny of COVID-19 Vaccination Claims
On May 3, 2021, the U.S. Dept. of Health and Human Services announced a program to cover costs of administering COVID-19 vaccines to patients whose health plans either do not cover vaccination fees or cover them with patient cost-sharing, effective with date of service December 14, 2020
May 21, 2021
Enhance your point-of-service collections while simultaneously enhancing the patient experience
“Nothing will kill patient experience faster than getting a bill two weeks after you’ve been seen and not knowing it’s coming.” Susan Milligan shows how to execute step-by-step tips on establishing a successful POS program that enhances patient experience.
May 17, 2021
CMS: Post required price transparency information or face penalties of $300 per day
What you need to know about how CMS has started issuing its first round of warning letters to hospitals not in compliance with the hospital price disclosure rule.
May 12, 2021
Unbilled Management | OPERATOR INSIGHTS | Healthcare Revenue Cycle Services
Julie speaks with Arthur Loya (AVP of revenue cycle billing services) about Healthcare billing management--specifically Unbilled Management. This combines discharged not final billed and discharged not final submitted, while relying heavily on strong cross-departmental effort. Most importantly, working with a healthcare billing management specialist like Arthur is the FASTEST way to turn cash around.
May 5, 2021
Diversity, Equity & Inclusion | OPERATOR INSIGHTS | Workplace DEI Best Practices
Julie speaks with Rich Lewis (AVP of Culture & Inclusion) about diversity, equity, and inclusion in the workplace. Rich shares some DEI best practices, the purpose of DEI, common misconceptions, the value these programs provides to your workforce, how to approach starting a program at your company, and more
May 5, 2021
4 key challenges to overcome before implementing a telehealth strategy
Telemedicine is being touted for its potential to provide superior care at a lower cost than traditional methods, but significant challenges could get in the way of success.
April 5, 2021
Hold on all Medicare claims while awaiting Congressional action may present risk of cash delays for providers
A likely Congressional action to extend the suspension of the 2% sequestration on Medicare payments is welcome news to healthcare providers, but a hold on claims until such action is taken may cause temporary headaches in the form of potential cash delays.
April 1, 2021
Bedside Physicians Do's and Don'ts
March 30, 2021
Why PASTA is Now On the UM Menu
Janet G Pickstock MD, MBA, MHCDS Physician Advisor Ensemble Health Partners talks about Physician Advisor STAtus recommendation (PASTA) for our heroes at the bedside: A recipe for changing the culture of physician to physician communication in Utilization Management.
March 30, 2021
Changes to the CMS Inpatient Only List
Chief Physician Advisor Kheit Trinh MD, talks about changes to the CMS’ Inpatient Only List that have a direct financial impact to health systems.
March 12, 2021
CMS Hospitals Without Walls
The Centers for Medicare and Medicaid Services (CMS) has expanded their Hospitals Without Walls program through the Acute Hospital Care at Home program.
March 11, 2021
CMS Implemented Prior Authorization Process
Ensemble Health Partners provides recommendations for health care providers regarding CMS Implemented Prior Authorization Processes.
March 1, 2021
Operator Insights: 2021 ACA Special Enrollment Period
Due to the COVID-19 Public Health Emergency, the Centers for Medicare and Medicaid Services (CMS) has announced a special enrollment period (SEP) for Affordable Care Act individual health insurance plans beginning this week.
February 16, 2021
Just The Facts: Key Information About Price Transparency
Patients should understand the different aspects of Price Transparency. Within, we provide information to help patients understand the key facts of Price Transparency, as well as how the rule will impact the healthcare industry.
January 20, 2021
Operator Insights: Utilization Management
Operator Insights is a Revenue Cycle Management thought leadership series from Ensemble Health Partners, who was voted Best In KLAS for healthcare revenue cycle outsourcing in 2020. In this episode, Julie talks Utilization Management with Dr. Robert Wagner (EVP of Physician Services) about physician advisors, UR nurses, and the overall value of UM services.
January 7, 2021
2021 Annual Code Updates
Ensemble Health Partners CDM Team provides you the latest 2021 Industry and Code updates for CPT, CMS, 40B Programs, Price Transparency and more.
December 29, 2020
6 Tips For A Better Price Transparency Patient Experience
Before COVID-19 took the health care spotlight, you may have heard about a Centers for Medicare and Medicaid Services (CMS) initiative referred to as Price Transparency.
December 15, 2020
The Importance of HCC Coding
Hierarchical Condition Category (HCC) coding is the risk adjustment (RA) model that is used by the Centers for Medicare and Medicaid (CMS) for determining future healthcare costs associated to a specific patient.
December 10, 2020
COVID-19: Vaccine and Treatment Billing Guide Under Medicare
Over the last several weeks, the Federal Drug Administration (FDA) has approved, or is in the process of approving, Emergency Use Authorization (EUA) to Pfizer, Moderna, Eli Lilly and Regeneron Pharmaceuticals for their COVID-19 Vaccines or Infusion Treatments.
December 6, 2020
Passionate Pioneer Podcast: Lifting Revenue Cycle Performance
During this episode, we spent time with Jim Gaffney, the Chief Strategy Officer for Ensemble Health Partners, a leading innovator in revenue cycle management. Jim and his team empower healthcare providers to improve financial outcomes and patient experiences with an unrivaled depth of expertise and best-in-class technologies.
December 1, 2020
Price Transparency: Requirements and the Impact to Patient Experience
Ensemble Health Partners subject matter experts examine what price transparency is, how it affects patients and how it affects the patient experience.
November 24, 2020
COVID-19: Treatment Billing Guide Regeneron EUA
November 21, 2020, the Federal Drug Administration (FDA) granted Emergency Use Authorization (EUA) to Regeneron Pharmaceuticals for its Regeneron infusion for COVID-19 treatment.
November 23, 2020
Operator Insights: Revenue Recovery
Operator Insights is a Revenue Cycle Management thought leadership series from Ensemble Health Partners, who was voted Best In KLAS for healthcare revenue cycle outsourcing in 2020.
November 23, 2020
Becker's Healthcare Podcast | Judson Ivy, CEO of Ensemble Health Partners
This episode features Judson Ivy, CEO of Ensemble Health Partners. Here, they discuss current trends he’s seeing in revenue cycle, points of pride he has in Ensemble, and more.
November 12, 2020
COVID-19: Treatment Billing Guide Bamlanivimab EUA
Under an executive order from President Trump, the Federal Drug Administration (FDA) has granted Emergency Use Authorization (EUA) to Eli Lilly for Bamlanivimab for the treatment of COVID-19.
November 12, 2020
Cybercrime: A Troublesome Consequence of a Continuing Pandemic
Cybercrime is flourishing during the COVID-19 public health crisis. According to the Federal Bureau of Investigation (FBI), daily digital crime rose 75% from the start of stay-at-home restrictions until June.
October 21, 2020
Summary of October 1st, 2020 ICD-10 Code Updates
Ensemble's "Queen of Codes" Staci Booth provides a vital summary of the ICD-10 Code changes coming October 1st, 2020 and Q&A recap from her recent webinar regarding ICD-10 changes and COVID 19 specifications.
October 12, 2020
Documentation Tips: "Think in Ink"
Accurate and complete documentation of medical necessity is key for both the patient and your organization. When done right, documentation leads to a higher quality patient experience, improved communication and sound clinical and financial outcomes.
September 24, 2020
5 Steps to Enhance the Revenue Cycle Associate Experience
Enhancing the associate experience requires revenue cycle organizations to be vulnerable, transparent, and collaborative with all levels of associates. This starts with your front-line workforce and is complimented by the values of your organization.
September 8, 2020
10 Tips for Managing your Hospital Billing Watch List
Through working with Epic clients for the last 16 years on implementations, system assessments, and Epic optimization projects, rarely have I come across a client that had a good handle on the Watch List section of their Hospital Billing Overview dashboard.
September 7, 2020
POPPING THE QUESTION: DOES EMPLOYEE ENGAGEMENT FEED PATIENT EXPERIENCE?
Healthcare organizations seek various methods to develop and improve patient experience, but one aspect that can be easily overlooked is employee engagement. Unfortunately, overlooking this relationship can sacrifice a match made in heaven. “Recent studies indicate that focusing on employee satisfaction and subsequent employee retention may be strong catalysts to patient satisfaction.”1 It is not surprising, then, that employees — and their level of engagement — are the foundation for strong patient experience performance.
August 20, 2020
Operator Insights: Patient Experience
Susan Milligan talks about what patient experience is, the importance of EVERY interaction with a patient and figuring out how to improve patient experience.
August 18, 2020
Out of the Dark: Breaking Down the Two-Midnight Rule
In one of its rarer moments, the government, specifically the Centers for Medicare & Medicaid Services (CMS), tried to simplify one of its regulations. The status of a hospitalized patient (inpatient versus outpatient) was confusing to patients and doctors alike. So, effective October 1, 2013, CMS put into effect the now famous Two-Midnight Rule.
August 12, 2020
Operator Insights: Client Delivery
Julie Roberts talks with Carl Swart about the role of client delivery within revenue cycle management. Interested in working in a client delivery role? Carl reveals the 5-part on-boarding and training process for to position oneself to thrive. Further, how do you work with the tension that can exist between the responsibilities around performance and the relationship?
July 21, 2020
COVID-19 and Sepsis: Demystifying Denials during the Pandemic
Unfortunately, sepsis is a common condition found in many hospitalized patients. It’s also a known complication of COVID-19, causing death in many patients during the pandemic. Yet despite its prevalence and morbidity, hospitals are facing a surprising number of denials for sepsis care.
July 1, 2020
Forbes Books Radio Podcast | Part Two: Who will lead? | Allan Calonge
Jennifer wraps up her chat with Allan Calonge, Chief People Officer of Ensemble Health Partners, Allan Calonge. In part two, Jennifer and Allan talk about how Ensemble measures their team’s performance and the importance of being a compassionate leader that can be direct with kindness and passion.
June 18, 2020
Operator Insights: Applying Nursing Skills in Rev Cycle.
In this episode, Julie Roberts talks with Alison Bowlick about the critical role of Clinical Documentation Improvement for proper healthcare reimbursement. As a nurse, Alison has a lot of bedside experience, but as a clinical documentation specialist, how has her role changed?
June 15, 2020
Forbes Books Radio Podcast | Part One: Who will lead? | Allan Calonge
This week, Jennifer is joined by the Chief People Officer of Ensemble Health Partners, Allan Calonge. Judson Ivy founded Ensemble Health Partners in 2014 after spending years as a revenue cycle executive in large hospital corporations. Ensemble Health has grown to over 5,000 employees in just 6 years and Allan tells Jennifer how their team were able to grow that substantially in such little time.
June 4, 2020
Avoiding Denials During COVID-19
There is no doubt that hospitals and health systems are suffering financially amid the burden of COVID-19. Patient volumes are down, and already slim operating margins have shrunk, while labor, supply and medical equipment expenses continue to grow.
June 1, 2020
6 Tips For Leading With Compassion While Working Remotely.
The spread of COVID-19 and the surrounding events have impacted millions of lives. Whether you planned on taking meetings from a conference room or having lunch with coworkers, life is looking a lot different these days.
May 29, 2020
5 steps to ensure physician revenue cycle success during a crisis.
With changing technologies, such as telehealth, ensuring minimal revenue cycle interruption during the COVID-19 pandemic presents new challenges for physicians and their organizations. Healthcare providers seek guidance about what code to use, what to include in their documentation and what place of service to use — all while navigating an evolving reimbursement and regulatory landscape.
May 28, 2020
Social Distancing Can't Mask a Great Patient Experience.
Finally hearing the news that your state is easing restrictions on elective surgeries as one of the first steps to reopening the economy is music to every healthcare system’s ears. It can also be overwhelming as we navigate our way into a “new normal.”
May 20, 2020
Breaking Out of a Pandemic POS Mindset.
Many organizations paused point of service (POS) collections during the pandemic. As important as it is to develop new collection methods or strategies, getting POS collections back on track is critical. Below are four insights on how to do just that.
May 16, 2020
Surviving in a Work from Home Environment
Working from home: dream come true or biggest nightmare? Your level of responsibility and whether you are an introvert or extrovert can influence how you feel about it. With COVID-19 precautions requiring many people to relocate from an office to a home environment, this question keeps popping up.
April 30, 2020
Beckers Healthcare Podcast | Lessons Learned During COVID-19
In this podcast, two leaders from Ensemble Health Partners - Staci Booth, Director of Coding Education, DRG Validation, and Appeals and Kathryn Vermillion, Senior Director of Clinical Documentation Improvement - discuss COVID-19 and the pandemic's potential long-term impacts for the healthcare industry.
April 22, 2020
Guide to COVID-19 Telehealth and Telemedicine
CY 2020 services and guidance for telehealth and telemedicine.
April 15, 2020
Servant Leadership During a Pandemic
March 2020 is a month we’ll never forget—as people, as professionals, as leaders and as a nation. Across four tumultuous and nerve-wracking weeks, Ensemble Health Partners, like many U.S. companies, had to rethink its service delivery logistics in light of a spiraling pandemic.
April 12, 2020
How to Lead in a Virtual Environment.
The COVID-19 pandemic is changing the way we operate for the foreseeable future, and leaders must adapt to support the business and our associates effectively. Self-quarantining and social distancing are making remote work a reality.
April 10, 2020
COVID-19 CMS Waivers Fact Sheet
We are committed to bringing you exceptional revenue cycle results so you can focus on caring for your patients and communities. Our team of subject matter experts has been monitoring and preparing for the latest COVID-19 updates.
March 30, 2020
NAHAM Connections | Acting With Empathy During COVID-19
Fear, frustration, panic, anger, confusion … we have all been dealing with these emotions (and many others) during the COVID-19 pandemic. The amount of media attention, whether social media or news media, keeps these emotions at or near the surface seemingly all the time. Our way of life has been impacted in ways we never anticipated or imagined. As a result of these significant disruptions, it is crucial for all of us to demonstrate empathy in each and every encounter — for our patients, our coworkers and ourselves.
March 28, 2020
Frontlines of COVID-19
In this webinar you'll hear a series of Doctors sharing their experience and knowledge around fighting the COVID-19 novel virus pandemic. Dr. Trinh and Dr. Johar are physician advisors at Ensemble Health Partners.
March 20, 2020
Navigating Patient Access during COVID-19
Patient Access is often referred to within Revenue Cycle as the “front line” or front-end operations. By definition, the term front line is used to describe the military members closest to battle. With the ongoing state and federal restrictions limiting public gatherings, school closures, social distancing, and hospitals experiencing high volume Emergency Department visits, Patient Access is now more than ever a “front line” in the COVID-19 pandemic.
March 20, 2020
State 1135 Waivers to CMS
Overnight, there were about a dozen new state 1135 waiver approvals. Our team is continuing to track these ongoing updates and document them in this guide:
Updated April 2020
March 18, 2020
COVID-19 and Epic: Patient Friendly Billing Guide
CMS has granted certain “blanket waivers” as a result of the Novel Coronavirus Disease (COVID19) pandemic. However, it is important to understand that those blanket waivers only pertain to federal requirements. For all impacts and issues governed by Medicaid laws and regulations, States must individually apply to CMS to avail themselves of Section 1135 waivers. Moreover, state-submitted 1135 wavier requests are the best opportunity for states to submit all the “case-by-case” waiver or modification requests as there is no one size fits all solution to mitigating the impact of a global pandemic.
March 16, 2020
NAHAM Connections | Using Empathy to Create a Positive Patient Experience
Fear, frustration, panic, anger, confusion… we have all been dealing with these emotions (and many others) during the COVID-19 pandemic. The amount of media attention, whether social media or news media, keeps these emotions at or near the surface seemingly all the time. Our way of life has been impacted in ways we never anticipated or imagined. As a result of these significant disruptions, it is crucial for all of us to demonstrate empathy in each and every encounter — for our patients, our coworkers and ourselves.
March 10, 2020
Operator Insights: Revenue Integrity
In this premiere episode, Julie Roberts talks with Lena Tisten about an often misunderstood part of RCM -- revenue integrity. So what is revenue integrity?
March 4, 2020
CIO Applications | What's next for Robotic Process Automation
Robotic Process Automation (RPA) allows organizations to automate repeatable, rule-based processes and organizations across industries are deploying this technology to create a competitive advantage for themselves.
February 26, 2020
Hospital Data Breach Playbook
Medical data breaches are on the rise, making patient data security one of the most pressing issues in the healthcare industry. In 2019, more than 41 million healthcare records were either exposed, stolen or inappropriately disclosed.
February 17, 2020
Point Solutions: Understanding Patient Status
Ensemble’s Chief Clinical Officer and Chief Physician Advisor Khiet Trinh, MD, MBA, CPE is demystifying patient status. Ensemble Health Partners is a purpose-driven revenue cycle outsourcing company, and we're doing our part to change the problems facing American Healthcare.
February 13, 2020
POINT SOLUTIONS: HOW DENIALS IMPACT PATIENT SATISFACTION
Hospitals and health systems focus on preventing denials for many reasons. Perhaps they want to get tighter control over shrinking margins, preserve revenue integrity or accelerate cash. While these are valid motives, organizations often struggle most with the piece of the denial lifecycle where providers feel they have the least control: how denials impact a patient and how they may alter perceptions or the level of trust the patient population has in a care provider.
February 12, 2020
Operator Insights: Negotiating Better Payor Contracts.
Must haves in your next payor contract
February 5, 2020
TEDX CINCINNATI WOMAN: IS LEADERSHIP JUST KINDNESS?
In order to lead large groups of people, do we first need to learn how to lead just one person at a time? A random encounter with a stranger on an airplane suggests that anyone can be a leader at any time if we focus our time and energy on just being kind when people need it most. Sarah Armstrong shows us how to lead with just one person. Sarah Armstrong currently serves as the Chief Operating Officer for a rapidly growing healthcare revenue cycle company. Upon becoming a widow at the age of 31, Sarah used the life-altering experience to help shape and craft the way she looks at life, love, people and leadership.
January 30, 2020
2020 Coding Updates Guide
Ensemble Health Partners brings you the calendar year 2020 coding updates that you need to know about.
January 15, 2020
The Healthcare Investor | A View From the Top: Judson Ivy
This series features interviews with C-suite leadership of private equity-backed portfolio companies. This installment features Judson Ivy, founder and CEO of Ensemble Health Partners.
January 13, 2020
Using AI and physician education to bolster CDI teams
Many health system leaders see their organizations as locked in an adversarial contest with payers over reimbursement. Claims are often denied based on clinical indicators or the fact that complications or comorbidities were only documented once. These coding issues can lead to inadequate reimbursement, as payers will downgrade reimbursement if the claim lacks specificity.
January 9, 2020
Purpose Driven Revenue Cycle
Revenue cycle excellence translates to better better patient experiences and better health outcomes.
January 1, 2020