Reversing Losses with Smart Hospital Revenue Cycle Management

Solutions for smart hospital revenue cycle management continue to evolve as technologies, workflow processes, and cross-team integration strategies improve.  Even so, a recent report showed larger hospitals are on average leaving $22 million in revenue capture on the table.  What can be done to address this?

Solutions for smart hospital revenue cycle management continue to evolve as technologies, workflow processes, and cross-team integration strategies improve.  Even so, a recent report showed larger hospitals are on average…

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Failure to Repeal the ACA Sparks Debate Over Medicaid Cuts and Single-Payer

Will Medicare and Medicaid spending be cut or only capped on future growth? Is moving to a single-payer healthcare system a possibility in the near future? We examine these questions that linger in the minds of healthcare leaders and finance officers in detail.

Will Medicare and Medicaid spending be cut or only capped on future growth? Is moving to a single-payer healthcare system a possibility in the near future? We examine these questions that linger…

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MIPS Quality Payment Program Criticized

Is the MIPS program from CMS what providers need for smart Medicare payments and rewards? Not all of the healthcare stakeholders, including hospitals, physicians and related groups, are happy with current MIPS Quality Payment Program rules, though some see the changes proposed for the next couple of years as positive.

Is the MIPS program from CMS what providers need for smart Medicare payments and rewards? Not all of the healthcare stakeholders, including hospitals, physicians and related groups, are happy with current…

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Improving Hospital Claim Collection Rates

Regarding claims management, the holy grail for hospitals continues to be a high clean claim rate… but how do you get there?  What KPIs — Key Performance Indicators — does your revenue cycle team follow?  Is the clinical side dialed into the process?  We take a look at some recommendations in this article.

Regarding claims management, the holy grail for hospitals continues to be a high clean claim rate… but how do you get there?  What KPIs — Key Performance Indicators — does your revenue cycle team follow?  Is the clinical side dialed into…

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Focusing on Healthcare Audit Management

What should your hospital team focus on when it comes to auditing for services, fraud, coding and cyber security? When it comes to healthcare, the solution boils down to what you will benchmark, training, and the best methods for efficiency in your organization. A lot of industry leaders share the idea that audits are the best start toward better compliance management these days.

What should your hospital team focus on when it comes to auditing for services, fraud, coding and cyber security? When it comes to healthcare, the solution boils down to what you will benchmark, training, and the best…

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Electronic Prior Authorization Software Improves Revenue Cycle

Prior authorization is the name given to the process of establishing medical necessity for medical services, prescription medication, or medical equipment. Insurers require this approval prior to the patient obtaining services, except in emergency situations. Learn how technology can be used to streamline this process to help improve the revenue cycle processes. 

Prior authorization is the name given to the process of establishing medical necessity for medical services, prescription medication, or medical equipment. Insurers require this approval prior to the patient obtaining services, except in emergency situations. Learn how technology….

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Improving Hospital Point-of-Service Collections

In an era of high deductibles, how do you solve the patient collections problem? One solution is,”when hiring front-of-house staff, Gray [Josh Gray, VP of research at athena health] suggests establishing expectations and make clear that new hires understand collecting outstanding balances at the time of service is critical and hold them accountable.

In an era of high deductibles, how do you solve the patient collections problem? One solution is,”when hiring front-of-house staff, Gray [Josh Gray, VP of research at athena health] suggests establishing…

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Are Alternative Payment Models Working to Reduce U.S. Healthcare Spending?

We take a look at the current healthcare spending in the U.S. and examine how alternative payment models are designed to help reduce these costs. Then we will review recent articles that propose changes that would make alternative payment models more effective. 

We take a look at the current healthcare spending in the U.S. and examine how alternative payment models are designed to help reduce these costs. Then we will review recent articles that propose changes that would…

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2017 Healthcare Revenue Cycle Management Challenges Met by Technology

As the financial landscape of healthcare delivery changes in the United States, hospitals, providers, and ambulatory surgery clinics are faced with unique revenue cycle management (RCM) challenges…

As the financial landscape of healthcare delivery changes in the United States, hospitals, providers, and ambulatory surgery clinics are faced with unique revenue cycle management (RCM) challenges…

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Improve Your Healthcare Organization’s Claims Denial Management Processes

Successful management of claims denials is one of the most important aspects of a productive revenue cycle management process. Learn more about claims denial management and what steps your healthcare organization can take to improve this internal process. 

Successful management of claims denials is one of the most important aspects of a productive revenue cycle management process. Learn more about claims denial management and what steps your healthcare…

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Is Hospital Pricing Transparency Possible?

When it comes to hospital pricing transparency that states and consumer advocates want to see, few hospitals are able to implement true procedure cost reporting.  Why is that, and will it ever happen?  We review the latest news.

When it comes to hospital pricing transparency that states and consumer advocates want to see, few hospitals are able to implement true procedure cost reporting.  Why is that, and will it ever happen?  We review…

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Healthcare Payer News: Blockchains, Emergency Care and New Technology

Value paradigms, blockchains, and cloud services seem to be in the wind this year as the whole technology landscape shifts.   Add to this related policy changes from CMS to”increase choices and encourage stability”.  Will lower premiums materialize and be a help to the hospital revenue cycle? 

Value paradigms, blockchains, and cloud services seem to be in the wind this year as the whole technology landscape shifts.   Add to this related policy changes from CMS to”increase choices and encourage…

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Patient Access Management Challenges, News, and Progress

From providing hospital pricing transparency to patient collections to revenue cycle management and patient access to information, hospitals are currently facing an array of access management challenges. Join us as we explore the current news and updates about patient access management.

From providing hospital pricing transparency to patient collections to revenue cycle management and patient access to information, hospitals are currently facing an array of access management challenges. Join us as we explore…

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How Hospital Billing and Claims Management Processes Affect Revenue

Hospital billing and claims management processes have a clear and direct impact on the financial health of an organization. However, oftentimes healthcare executives blame poor performance on external factors, rather than analyzing internally. We take a deeper look at this issue and how hospitals can improve their practices to increase revenue. 

Hospital billing and claims management processes have a clear and direct impact on the financial health of an organization. However, oftentimes healthcare executives blame poor performance on external factors, rather than…

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Bundled Payments Off to Delayed Start

One prediction has it that in healthcare “bundled payments will account for 17 percent of reimbursements in the next five years.”  This as healthcare industry experts are continuing to call for mandatory implementation of bundled payments while CMS pushes back deadlines.  Go or no-go?  We take a look at the latest roundup of thoughts and advice.

One prediction has it that in healthcare “bundled payments will account for 17 percent of reimbursements in the next five years.”  This as healthcare industry experts are continuing to call for mandatory implementation of bundled payments while CMS…

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