Category: Blog

Top-3-Revenue-Cycle-Hurdles

Top 3 Critical Challenges for Revenue Cycle Leaders in 2024

 As we approach the end of 2023 and the holiday season draws near, revenue cycle leaders ought to contemplate including these three challenges in their organization’s roster of New Year’s resolutions. Automating Payer Processes: Similar to healthcare organizations, payers have also started embracing automated solutions, intensifying challenges in managing denials and causing delays in payment […]
Learn More
Rising-Denied-Claims-impact-on-Cash-flow-Delays-for-Hospitals

Rising Denied Claims: Impact on Hospitals’ Cashflow Delays

Hospital bills that remain unpaid for over 90 days often stem from claims that were initially rejected by payers. Additionally, the longer a bill is initially declined, the greater the likelihood that it will take more than 90 days to be resolved. These discoveries are highlighted in a recent report by Healthcare Consulting Company, which […]
Learn More
Christmas -ICD-10 injury codes

ICD-10 Codes to Ring the Bell on Christmas Season

December is the Christmas, a holiday season, it’s the right time to decorate, indulge in tasty treats, and gather with loved ones. It’s known to us that all the festive celebration brings the risk of injuries and illness. Note down these ICD-10 codes for the christmas season, which will help physicians to diagnose emergency rooms, […]
Learn More
The-Evolution-&-Challenges-of-Recovery-Audit-Contractor-Audits

Evolution of Recovery Audit Contractor (RAC) Audits: Challenges, Changes, and Current Landscape

The inception of Recovery Audit Contractor (RAC) audits dates back to 2005, reaching their zenith around 2010 before encountering a deceleration amidst the COVID-19 period. In 2006, Congress granted the Centers for Medicare & Medicaid Services (CMS) the authority to launch the Recovery Audit Contractor program across three initial states: New York, Florida, and California. […]
Learn More
Impacts of Claim Denials on Revenue Cycle

How Claim Denials and Payer Audits Impacts Healthcare Revenue Cycle

Denial rates, notably within Medicare Advantage, are on the rise, impacting both hospital revenue cycles and patient care, remarked the executive director of a Minnesota-based large multispecialty health care organization focused on Revenue Cycle management. Despite the organization reporting a favorable margin this year, it falls short in achieving profits comparable to those of insurers, […]
Learn More
Four-health-tech-trendsare-about-to-explode-in-2024

The Future of Healthcare: 4 Tech Trends Shaping 2024

The traditional and conservative realm of healthcare has experienced significant and swift technological upheaval in the last ten years. The surge of generative AI and Large Language Models (LLMs) has outpaced any previous innovation wave, revolutionizing the landscape. While lauded as potential remedies for numerous healthcare challenges, these innovations confront the digital health industry with […]
Learn More

Navigating Denial Management Challenges in Revenue Cycle Management

In the intricate realm of healthcare revenue cycle management (RCM), the substantial challenge revolves around handling denied claims. Scarcity of resources, understaffing, and restricted capacity frequently lead to difficulties in resolving denied claims, where an alarming 82% to 90% are considered potentially preventable. RCM teams can optimize time and revenue recovery by employing proactive strategies […]
Learn More

CPT® 2024 Update: New Codes and Guidelines

2024 CPT Coding updates:  Take a look at the updates in CPT coding and guidelines for professional services. Every year, on January 1st, updated CPT® codes and coding guidelines emerge, introducing new, revised, and eliminated codes. For instance, in CPT® 2024, there are 230 new codes, 70 revised ones, and 49 removed codes. Notably, no […]
Learn More
8-Powerful-Strategies-to-minimize-Denied-Claims

8 Successful Tactics for Reducing Denied Claims 2024

Roughly 65% of rejected claims aren’t reprocessed for resubmission (Zindl, 2021). As one of the healthcare industry’s numerous challenges, the upward trend of denied claims persists, with many left unaddressed. This has repercussions for both providers and patients alike. When denied claims remain unsubmitted, providers face substantial losses. Beyond revenue, these rejections strain staffing resources. […]
Learn More
7-Strategies-to-improve-medical-coding-quality

7 Strategies to Support Medical Coders Struggling with Quality and Accuracy

Help your medical coders facing difficulties in maintaining coding accuracy by implementing a focused strategy. Medical coders hold a crucial position in healthcare, translating intricate medical data into standardized codes essential for billing, research, and patient treatment. The importance of accurate and high-quality medical coding cannot be overstated, as errors may result in financial setbacks […]
Learn More
x