Undoubtedly, hospital readmissions are costly for both healthcare providers and patients. However, many readmissions can be avoided through better care coordination, patient education, and discharge planning.

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STRATEGIES FOR REDUCING READMISSION PENALTIES THROUGH IMPROVED
BILLING PRACTICES

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STRATEGIES FOR REDUCING READMISSION PENALTIES THROUGH IMPROVED
BILLING PRACTICES
Undoubtedly, hospital readmissions are costly for both healthcare providers and patients. However, many
readmissions can be avoided through better care coordination, patient education, and discharge planning. To
address this, the Centers for Medicare and Medicaid Services (CMS) introduced the Hospital Readmissions
Reduction Program (HRRP). Under this program, hospitals with high readmission rates face penalties,
impacting their revenues. This has led many hospitals to adopt strategies to reduce readmissions and avoid
penalties.
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reducing-readmission-penalties-through-improved-billing-practices
Impact of Readmissions on Providers
When patients are readmitted to the hospital within 30 days of discharge, it often signals a
breakdown in care or communication. Although some readmissions are unavoidable, many result
from inadequate follow-up, poor discharge instructions, or patient confusion over medications.
In fact, high readmission rates can lead to significant financial penalties for healthcare providers under HRRP.
The penalties can be as high as 3% of a hospital's Medicare reimbursement, which is substantial for many
hospitals. These penalties can also affect a hospital’s reputation, as the readmission rates are publicly reported.
As a result, hospitals are increasingly focused on reducing readmissions by improving patient care and
ensuring that patients leave the hospital fully prepared to continue their recovery at home.

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Medical Billing Strategies to be Followed
1. Improving Care Transitions
One of the key ways to reduce readmissions is by improving care transitions. This means ensuring patients
transition smoothly from the hospital to their home or another care facility. In fact, effective coordination
between care teams, follow-up visits, and clear communication with patients can help prevent unnecessary
readmissions. Also, billing processes can be optimized to track and coordinate these care transitions,
ensuring that providers are reimbursed for post-discharge care and that patients are supported during this
critical time.
2. Early Discharge Planning
Starting discharge planning early is another strategy to reduce readmissions. Hospitals can use case
managers or care coordinators to begin discharge planning as soon as the patient is admitted. This allows
time to assess the patient’s needs, arrange necessary services like home health care or follow-up
appointments, and ensure they understand their care plan. Proper documentation and billing for these
services can also ensure that hospitals are reimbursed appropriately for the care they provide after
discharge.
STRATEGIES FOR REDUCING READMISSION PENALTIES THROUGH IMPROVED BILLING
PRACTICES

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3. Enhancing Patient Education
Educating patients about their medications, care instructions, and follow-up appointments reduces
readmissions. Hospitals can use billing codes for patient education services, ensuring that this important
aspect of care is not overlooked. Using the teach-back method, where patients repeat back instructions to
confirm their understanding, can further improve outcomes and reduce the risk of readmissions.
4. Medication Reconciliation
Medication errors are a common cause of hospital readmissions. Medication reconciliation, which involves
reviewing and updating a patient’s medication list at every transition of care, can help prevent these errors.
This strategy ensures the patient’s medications are accurate and any potential issues are addressed before
discharge. Proper billing for medication reconciliation services can also ensure that hospitals are
compensated for this crucial step in patient care.
5. Identifying High-Risk Patients
Some patients are at higher risk of readmission than others. Hospitals can use predictive analytics or other
tools to identify these patients and enroll them in programs like telehealth or remote patient monitoring
(RPM). These programs allow healthcare providers to track patients’ conditions more closely and intervene
before a readmission is necessary. Billing for telehealth and RPM services can help hospitals offset the cost
of these programs while reducing readmissions.
STRATEGIES FOR REDUCING READMISSION PENALTIES THROUGH IMPROVED BILLING
PRACTICES

5. STRATEGIES FOR REDUCING READMISSION PENALTIES THROUGH IMPROVED BILLING
PRACTICES
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6. Understanding HRRP Policy
Hospitals must clearly understand the Hospital Readmissions Reduction Program (HRRP) to
manage their readmission rates effectively. This includes knowing which conditions are included
in the program, such as heart failure, pneumonia, and chronic obstructive pulmonary disease
(COPD). Hospitals can use this information to target their readmission reduction efforts and
ensure they comply with CMS guidelines. Accurate billing for the care provided to these patients
is essential to avoiding penalties.
7. Using Case Managers
Case managers play a crucial role in reducing readmissions by coordinating care and
ensuring that patients have everything they need before leaving the hospital. This
includes arranging for equipment, follow-up appointments, and transportation.
Hospitals can bill for the services provided by case managers, ensuring that this
essential role is financially supported while improving patient outcomes.

6. STRATEGIES FOR REDUCING READMISSION PENALTIES THROUGH IMPROVED
BILLING PRACTICES
HTTP://WWW.247MEDICALBILLINGSERVICES.COM
Outsourcing to 24/7 Medical Billing Services
One of the other effective strategies for reducing readmission penalties is outsourcing medical
billing to a company like 24/7 Medical Billing Services. Such a company is an expert in managing
the complex billing processes involved in post-discharge care, medication reconciliation, and
telehealth services. In fact, their team can help hospitals ensure that all services related to reducing
readmissions are accurately documented and billed, maximizing reimbursement and reducing the
financial impact of readmission penalties.
Moreover, 24/7 Medical Billing Services can also help hospitals stay updated with changes in CMS
regulations, ensuring compliance and reducing the risk of penalties. Additionally, outsourcing can
improve billing accuracy, reduce claim denials, and help hospitals recover lost revenue. This makes
outsourcing to such a company an effective strategy for hospitals looking to reduce readmissions and
maintain financial stability.

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About 24/7 Medical Billing Services:
24/7 Medical Billing Services is the nation’s leading medical billing service provider
catering services to more than 42 specialties across the entire 50 states. You can rely
on us for end-to-end revenue cycle management. We guarantee up to 10-20%
increase in the revenue with cost reduction of your practice for up to 50%.
Call us today at 888-502-0537 to know more on how we can help boost profitability
for your practice.
Media Contact:
24/7 Medical Billing Services,
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3001 Greenfield Drive, Marietta GA, 30068
Texas:
2028 E Ben White Blvd, #240-1030 Austin TX, 78741
Tel: + 1 -888-502-0537
Email - info@247medicalbillingservices.com
STRATEGIES FOR REDUCING READMISSION PENALTIES THROUGH IMPROVED BILLING
PRACTICES