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The IRS regulation known as “501r” enacted in 2016 includes a provision that requires hospitals to “make reasonable efforts to determine whether an individual patient is eligible for assistance under the hospital’s financial assistance policy before engaging in extraordinary collections against the individual.”   IntelNet—CaptureNet’s Presumptive Financial Assistance Solution While many of the presumptive financial assistance systems involve generic scoring solutions developed from national population datasets, CaptureNet creates a customized model that is much more comprehensive and accurate. Its custom scoring solution draws...

Expensive and Frustrating Process Gaps   MAP Award recipient, for a large non-profit health system, I oversaw the installation of Epic. So many things about Epic were better than our system at the time…. Unfortunately for the Revenue Cycle side, countless more were not. Many of the automated processes that we had in place before Epic, were not available after conversion. Having to add staff for the new manual processes required was in opposition to our long-standing expense control best practices, which...

Mary Lee Decoster is no stranger to the challenges faced by professionals working within the hospital financial management field. Mary Lee is a 50-year industry veteran. In this interview, Mary Lee shares lessons she has learned throughout her impressive career.   CaptureNet (CN):  Thank you for agreeing to sit down with us for this interview!  Please give our community an overview of your career experience. Mary Lee Decoster (MLD): I’ve worked in healthcare receivables management for my entire career – over 50 years...

According to the CDC, the Affordable Care Act has decreased the uninsured population in the United States to 9.1%.  As the number of uninsured Americans has declined, the number of Americans covered by High Deductible Health Plans (HDHPs) has increased significantly. The latest census data provided by the America’s Health Insurance Plan (AHIP) reports over 19.7 million Americans have HDHPs with these plans accounting for approximately 36% of all plan types.  Many of the individuals subscribing to HDHPs are ill-informed about...

Have you ever considered where you may be accepting the status quo with your current practices? Are there areas in your organization you are challenged by third parties to review, but a lack of time or knowledge leads you to say, “We think we are doing a good job,” or “What we are doing is ‘good enough’”? How do you know if “good enough” is truly “good enough”? We understand. We challenge our prospective clients to challenge the status quo of their...