Harmony Insight

Revenue Cycle Management (RCM) is the backbone of healthcare finance, encompassing every step spanning from patient registration to final payment. However, many organizations face recurring pitfalls that can drain revenue, frustrate staff, and diminish patient satisfaction.   Here’s a look at the most common RCM pitfalls and actionable strategies to avoid them.  Incomplete or Inaccurate Patient Information  One of the most frequent RCM errors is collecting incomplete or incorrect patient data during registration. Even minor mistakes like a misspelled name or wrong insurance ID can lead to claim denials and payment delays. How to Avoid:  Train front-desk staff to verify all…

Outpatient Clinical Documentation Integrity (OP CDI) programs are essential for healthcare organizations aiming to improve documentation accuracy, ensure compliance, reduce denials, and optimize reimbursement. As care shifts to outpatient settings, the need for robust CDI programs outside the hospital grows. Here are seven key steps and best practices for implementing a successful outpatient CDI program, supported by industry guidance and expert recommendations. 1. Define Clear Goals and Scope Set specific objectives for your CDI program, such as improving risk adjustment scores, reducing claim denials, enhancing quality measures (e.g., MIPS/MACRA), and ensuring accurate reimbursement. Also, determine the scope of the program.…

Healthcare organizations are increasingly turning to contractors for non-clinical roles to address workforce challenges and adapt to evolving operational demands. Contract workers offer flexibility, specialized skills, and cost-effective solutions, making them a valuable asset in the healthcare industry. Here are the advantages of hiring contractors for non-clinical healthcare roles, positions that benefit from contract employees, and when you should hire. Advantages of Hiring Contractors in Non-Clinical Healthcare Contracting professionals for non-clinical healthcare roles provides several benefits for organizations 1. Flexibility and Scalability Contract workers allow healthcare organizations to scale their workforce based on project needs or seasonal demands. For instance,…

Harmony Healthcare provides healthcare organizations with the talent and resources needed to succeed today as well as the foresight to prepare for tomorrow’s challenges. In this employee spotlight, we’re excited to highlight Tiffani Bouchard, Director of Revenue Integrity Solutions. We spoke with Tiffani to share her advice for clients and coding and revenue integrity professionals as well as insights from her career journey. 1. Tell us about your journey in healthcare? I got my start in a small healthcare consulting firm more than 30 years ago. The consultants who worked with me quickly noticed I had an aptitude for coding…

In the complex world of healthcare, accurate clinical documentation serves as the backbone of effective revenue cycle management (RCM). It not only ensures accurate reimbursement but also fosters compliance, reduces errors, improves quality of care, and enhances operational efficiency. With healthcare organizations facing tighter margins and increasing regulatory scrutiny, the role of clinical documentation in safeguarding revenue integrity has never been more critical. Understanding Revenue Integrity Revenue integrity refers to the processes and systems that ensure healthcare organizations receive appropriate and accurate reimbursement for the services they provide. This involves accurate coding, documentation compliance, and adherence to payer regulations and…

Health Information Management (HIM) is a dynamic and rapidly growing field that bridges healthcare, technology, and business. HIM professionals play a critical role in managing, protecting, and analyzing patient data to ensure its accuracy, accessibility, and security. With the increasing adoption of electronic health records (EHRs) and the expansion of healthcare services, careers in HIM offer promising opportunities for growth and advancement. Here we share what HIM is, career opportunities in this field, and certifications you need to enter this field. What is Health Information Management? HIM involves the collection, organization, storage, and protection of healthcare data such as medical…

Harmony Healthcare recently hosted a webinar covering the many ICD-10-CM/PCS changes coming. April 1st will bring the following ICD-10-CM/PCS updates: Two ICD-10-CM guideline changes Multiple ICD-10-CM note changes 50 new PCS codes 12 deleted PCS codes It's not too late to join AHIMA-approved ICD-10-CM/PCS trainer, Dianna Foley as she walks through the upcoming April 2025 ICD-10-CM/PCS code updates. Watch the webinar on-demand, now!

Once again, on April 1, 2025, the ICD-10 classifications of CM and PCS have undergone a fresh update. While this isn’t the biggest update ever seen, there are still significant changes for coding professionals. Here we’ll share some of the key points. Important ICD-10-CM Updates There are no actual code changes to the ICD-10-CM code in the April, 2025 update. However, there are two important guideline changes: 1. Guideline I.C.1.g.1.h: (h) Asymptomatic individuals who test positive for COVID-19 For asymptomatic individuals who test positive for COVID-19 and there is no provider documentation of a diagnosis of COVID-19, query the provider…

Outpatient Clinical Documentation Integrity (OP CDI) is always evolving. Let’s test your knowledge.  On our LinkedIn page, we will have a series of questions so you can test your knowledge about OP CDI. Play along on Harmony Healthcare’s LinkedIn page and then come back here to check your answers. Question 1: A patient with HTN, HLD, CHF, and a history of CVA noted to have a BMI of 40.71 on the previous DOS last month. What is the HCC opportunity? Severe, morbid obesity Obesity BMI 40-40.5 and obesity Option 1 and 3 Explanation: From Coding Clinic 2nd quarter, pg 9.…