The Future of Healthcare: New Obstacles and Ongoing Challenges

The future of healthcare is uncertain and dependent on several factors, such as whether or not the ACA will be repealed. No matter which healthcare delivery model prevails, certain challenges and obstacles are inevitable in the years ahead.

The future of healthcare is uncertain and dependent on several factors, such as whether or not the ACA will be repealed. No matter which healthcare delivery…

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Healthcare Claim Denials on the Rise

Why do payers continue to deny 20% of claims payments to hospitals as they struggle to keep revenue cycles more profitable? Baby boomers are moving into their Medicare coverage phase. There are flaws in the Office of the Inspector General audits of hospitals, as alleged by the American Hospital Association.  Regulations are increasing. We take a look at the current situation and some creative solutions…

Why do payers continue to deny 20% of claims payments to hospitals as they struggle to keep revenue cycles more profitable? There are flaws in the Office of the Inspector General audits of hospitals, as alleged by…

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Healthcare Pricing Transparency Progress Slow

Does your hospital offer transparent pricing estimates for prospective patients? Some leading hospitals are already doing this and at some state websites you can compare average costs for procedures at facilities across the state. However, these are the exceptions, so we take another look at what’s going on in the national drive to achieve healthcare pricing transparency.

Does your hospital offer transparent pricing estimates for prospective patients? Some leading hospitals are already doing this and at some state websites you can compare average costs for procedures at facilities across…

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Is Single-Payer Healthcare the Right System?

When it comes to the healthcare system in the USA, much remains to be determined. Will the quality go down in a single-payer healthcare system, as taxes skyrocket? Or, will a reduction in costs be the result as advocates claim?  We take a closer look.

When it comes to the healthcare system in the USA, much remains to be determined. Will the quality go down in a single-payer healthcare system, as taxes skyrocket? Or, will a reduction in costs…

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Hospital Cybersecurity Tightens

Does our hospital have a senior executive that oversees cybersecurity? A new survey finds that 60 percent of healthcare organizations now have a chief information security officer in an age when cyber threats are increasing and the average breach costs your organization $2.2 million dollars.

Does our hospital have a senior executive that oversees cybersecurity? A new survey finds that 60 percent of healthcare organizations now have a chief information security officer in an age…

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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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