Reimbursement in the home health and durable medical equipment (DME) segments is challenging, with rising healthcare costs, complex payment models, high deductible health plans, supply and demand, customer service agreements and more. The COVID-19 pandemic is making it even more difficult for organizations to collect revenue owed to them for providing high-quality service to customers and patients.
With nearly one in five claims submitted to marketplace plans being denied, organizations are often willing to write off these claims rather than diagnose the root causes or make the necessary shifts to change course.
- develop and execute a proactive claims denial management strategy that increases net revenue;
- improve claims management efficiency;
- leverage data and technology most effectively;
- enhance staff competencies; and
- maintain their overall loyalty and commitment to providing stellar customer service.
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Director of Operations
Community Cares Health Solutions
Cheryl Henninger, RRT, CEAC, is the Director of Operations at Community Cares Health Solutions, specializing in community based clinical services in collaboration with other healthcare entities to reduce readmissions and avoidable emergency room visits in New York.
Cheryl is a registered respiratory therapist and a health care business consultant with more than 30 years of experience in the health care industry, including acute care, long-term care, primary care, pharmacy and DME. After several years in home care, Cheryl became an accreditation surveyor and an independent consultant specializing in business analysis. Cheryl’s expertise is in business operations, including new business developments and collaborations, management, reimbursement and compliance.
Cheryl has spent the last several years working with organizations and insurance companies to develop new chronic care initiatives aimed at cost savings through shared risk arrangements. Cheryl has a passion for positive health outcomes and enjoys working with healthcare and community partners to develop processes that are streamlined, yet progressive, and that encourage active partner participation and patient engagement.
Cheryl’s most recent successes include developing a holistic Chronic Respiratory Program and establishing a Respiratory Network in collaboration with other healthcare and community providers.