Getting a Clean Bill Out the Door

Alternative reimbursement methods like bundled payments have increased the complexity of getting a clean healthcare bill out the door. At the same time, margins are under pressure and the Department of Justice is ramping up its efforts to combat healthcare fraud. How can providers ensure they’re billing appropriately at a time when both the complexity and the stakes are so high?

To get a clean bill out of the door under bundled payments and other shared risk arrangements, the terms of every contract for all partners in an affiliated healthcare group must be understood and clearly communicated. Developing a robust contract management program – starting with a detailed understanding of current contract inventory, business terms and the credentialing status of providers under each contract – can help accomplish this.

In September’s HFM Magazine, Patrick Pilch, managing director and national leader of BDO Consulting’s Healthcare Advisory practice, and Paul Gallese, CEO of CenterLight Health System, explain how healthcare organizations can use contract management programs to ensure they’re submitting “clean claims.”