Category: Revenue Cycle Management

RCM Outsourcing

Healthcare: The Role of RCM Outsourcing and Technology

The U.S. healthcare industry, marked by its global leadership in spending, faces mounting pressures due to evolving care models, supply chain disruptions, regulations, labor shortages, and rising costs. To navigate these challenges, healthcare leaders are prioritizing quality care delivery while also optimizing administrative operations, including revenue cycle management (RCM). Outsourcing RCM has become a key […]
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Accounts receivable services

The Crucial Role of Accounts Receivable Services in Healthcare Practice

Accounts receivable (AR) services are often overlooked but play a crucial role in the financial health of any business. These services involve managing the process of collecting outstanding payments from customers for goods or services sold on credit. Effective AR management can significantly impact a company’s cash flow, profitability, and overall financial stability. The Importance […]
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Hidden EFT fees

Hidden EFT Fees Threaten Doctors’ Earnings and Patient Care

Most Americans prefer the convenience of direct deposit for their paychecks. However, imagine if your employer deducted a 2-5% fee from each paycheck to cover the cost of electronic payments. While it seems absurd, this is the reality for many doctors in the U.S. Healthcare insurers and their payment processors often impose hidden EFT fees […]
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Medical Documentation for Better Reimbursement

5 Key Ways to Improve Medical Documentation for Better Reimbursement

Providers and coders should work together to maximize reimbursement by ensuring accurate coding, which is validated by thorough medical documentation. By focusing on ways to improve medical documentation for better reimbursement, providers can enhance patient care and ensure accurate reimbursement. Here are five ways to improve documentation, patient care, and reimbursement: 1.  Avoid EHR Shortcuts […]
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Front-End Revenue Cycle Management

The Importance of Front-End Revenue Cycle Management in Healthcare

The success of a healthcare provider’s financial performance hinges heavily on the efficiency of its front-end revenue cycle management. While the mid and back-end processes, such as coding, billing, and denials management, often receive significant attention, it’s crucial to recognize the profound impact of pre-encounter activities on overall revenue cycle efficiency. Front-end revenue cycle encompasses […]
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medical claims processing

The Power of Business Process Automation in Medical Claims Processing

Medical claims processing has traditionally been a labor-intensive and error-prone task, involving manual data entry, verification, and adjudication. However, the advent of Business Process Automation (BPA) has revolutionized this process, making it more efficient, accurate, and cost-effective. Beyond the Basics: Advanced BPA Features While the core functionality of BPA in medical claims processing involves automating […]
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Medicare Advantage denials

Understanding the Rise of Medicare Advantage Denials: What Need to Know

Medicare Advantage (MA) plans, a type of private health insurance, have become increasingly popular among seniors. These plans offer additional benefits beyond traditional Medicare, but they also come with their own set of complexities.  One of the most significant issues faced by MA beneficiaries is Medicare Advantage denials for medical services. Recent data has revealed […]
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Healthcare Claim Denials

Reduce Healthcare Claim Denials and Improve Revenue: Proven Strategies

Healthcare Claim Denials can be a frustrating and costly setback. However, with the right strategies, you can significantly reduce denials and improve your revenue. This article outlines four effective approaches to handling denied claims and ensures timely resubmissions. 1. Establish a Routine for Denial Handling Create a standardized procedure: Develop a clear and efficient process […]
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HIPAA-compliant cloud computing

Mitigating Security Risks in Healthcare with HIPAA-Compliant Cloud Computing

The Role of HIPAA-Compliant Cloud Computing in Securing Healthcare Data: HIPAA-compliant cloud computing significantly mitigates security, privacy, and legal risks for healthcare organizations. Cloud computing is becoming increasingly popular in healthcare. As organizations seek scalable and accessible IT solutions, cloud vendors are providing the tools. However, ensuring HIPAA compliance is essential when using cloud services. […]
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2025 Medicare payment policies

Proposed Medicare Payment Policies for 2025

The United States Department of Health and Human Services (HHS) and Centers for Medicare and Medicaid Services (CMS) have proposed new 2025 Medicare payment policies for hospitals and ambulatory surgical centers (ASCs) that aim to increase access to care and advance health equity. These policies are outlined in the 2025 Hospital Outpatient Prospective Payment System […]
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